Viral kinetics and outcomes of adenovirus viremia following allogeneic hematopoietic cell transplantation.

Background Adenovirus (AdV) is a serious infection following hematopoietic cell transplantation (HCT). Little is known about AdV viral kinetics and optimal threshold for initiation of pre-emptive therapy. Methods Single-center retrospective study of 16 consecutive adult HCT recipients with detectable AdV identified over a five-year period. Results Median time to AdV reactivation after HCT was 176 days (IQR 86-408). Nine patients received cidofovir, although 14/16 had no tissue-invasive disease. Among treated patients, median duration of viremia was shorter when initiating treatment at viral loads 10,000 copies/mL (100 vs. 17%; P = 0.005). Conclusion AdV is associated with high all-cause mortality, especially for viremia >10,000 copies/mL. Delaying therapy until viremia reaches AdV levels ≥10,000 copies/mL was associated with more protracted infection and poor outcomes. Larger studies are needed. This article is protected by copyright. All rights reserved.