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- Title
Adenovirus infection and treatment with cidofovir in children after liver transplantation.
- Authors
Engelmann, Guido; Heim, Albert; Greil, Johann; Schmitt, Claus Peter; Flechtenmacher, Christa; Daum, Edith; Küsters, Uta; Schmidt, Jan; Meyburg, Jochen; Schnitzler, Paul
- Abstract
In a retrospective study, serum samples from 21 pediatric liver transplant recipients were analysed by quantitative real-time PCR for ADV infection up to 24 wk after Tx. ADV DNA was detected in serum of eight children after Tx, one of whom developed life-threatening fulminant hepatitis and sepsis. None of these children were symptomatic at the time of first detection of ADV DNA in serum after Tx. Seven children with positive ADV PCR had low adenoviral loads, showed no increase in viral load and remained clinically asymptomatic in the follow-up period of 24 wk. After 10 wk under immunosuppression one child presented clinically with adenoviral sepsis and severe necrotizing hepatitis. This patient revealed a dramatic increase of ADV from baseline titers up to 1.3 × 109 copies/mL serum within 10 wk after Tx. ADV was also detected in a liver biopsy of this child at 1.2 × 104 copies/cell and typed by sequence analysis as human ADV species C, type 6, a rarely detected ADV type and first described in a liver transplant patient. Immunosuppression was reduced in this patient immediately and the antiviral drug cidofovir administered intravenously followed by viral suppression and clinical improvement of the child.
- Subjects
ADENOVIRUS diseases; VIRUS diseases; LIVER transplantation; IMMUNODEFICIENCY; IMMUNOREGULATION; THERAPEUTICS
- Publication
Pediatric Transplantation, 2009, Vol 13, Issue 4, p421
- ISSN
1397-3142
- Publication type
Article
- DOI
10.1111/j.1399-3046.2008.01014.x