Adenoviruses

Published on 22/03/2015 by admin

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Last modified 22/03/2015

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Chapter 254 Adenoviruses

Adenoviruses (AdVs) are a common cause of human disease. Conjunctivitis is a familiar illness associated with AdVs, but these viruses also cause upper and lower respiratory disease, pharyngitis, gastroenteritis, and hemorrhagic cystitis. AdVs can cause severe disease in immunocompromised hosts. Outbreaks of AdV occur in communities and close populations, notably the military. No specific antivirals that are highly effective against AdVs are available. Vaccines are available for serotypes 4 and 7 but are used only for military populations.

Etiology

Adenoviruses were first isolated from human adenoidal surgical specimens in 1953. They are nonenveloped viruses with an icosahedral protein capsid. The double-stranded DNA genome is contained within the particle complexed with several viral proteins. Antigenic variability in surface proteins of the virion defines >50 serotypes grouped into seven species. Species differ in their tissue tropism and target organs, causing distinct clinical infections (Table 254-1). AdV can be shed from the gastrointestinal tract for prolonged periods and can establish chronic low-level infection of the tonsils and adenoids.

Table 254-1 ADENOVIRUS SEROTYPES WITH ASSOCIATED INFECTIONS

SPECIES SEROTYPE PREFERRED SITE OF INFECTION
A 12, 18, 31 Gastrointestinal
B1 3, 7, 16, 21, 50 Respiratory
B2 11, 14, 34, 35 Renal/urinary tract epithelium
C 1, 2, 5, 6 Respiratory
D 8, 9, 10, 13, 15, 17, 19a, 19p, 20, 22-30, 32, 33, 36, 37, 38, 39, 42-48, 49, 51 Ocular
E 4 Respiratory
F 40, 41 Gastrointestinal

Clinical Manifestations

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