Detection of Adenoviruses in Blood by Polymerase Chain Reaction

Adenoviruses have been recovered from virtually every organ system of man and have been associated with many clinical syndromes. There are at present 47 accepted serotypes of human adenoviruses. Many adenovirus infections are subclinical and result in antibody formation that is probably protective against an exogenous reintroduction of the same adenovirus serotype. The most common types are 1–8, 11, 21, 35, 37 and 40 (Hierholzer 1991, Schmitz et al 1983). Several groups of investigators, who have found low levels of adenovirus DNA persisting in peripheral blood lymphocytes, have suggested that lymphocytes have a role in the maintenance of persistence. It is known that Ad 1, Ad 2, Ad 5 and Ad6 (subgenus C) can persist in tonsils and adenoids for several years (Andiman and Miller 1982, Horvath et al 1986, Lavery et al 1987). Increasing incidence of adenovirus disease has been reported in primary immundeficiens and in organ transplant recipients (Hierholzer 1992, Flomenberg et al 1994). The results of other studies suggest that immunocompromised patients may be no more commonly infected with adenoviruses than normal hosts, but the outcome may be more serious and the illness may more likely be fatal (Cames et al 1992, Anders et al 1991, Teague et al 1991). Ad 1, Ad 2 and Ad 6 of subgenus C occurred among immunocompromised children, whereas Ad 4 and Ad 5 caused severe infection in adults (Hierholzer 1991). Persistent adenoviruses might explain the occasional clinical illness in immunocompromised hosts who could experience reaction of a latent infection at the time of immunosuppression.