Adenovirus Association with Graft versus Host Disease in Paediatric Bone Marrow Transplantation Recipients

Jaylan Ayoub 1,, Arwa Kamhawy 1, Kouka Saad Eldin Abd Elwahab 1,; Alaa Elhaddad 3, Abd Elrahman Zekri 2,

Adenovirus Association with Graft versus Host Disease in Paediatric Bone Marrow Transplantation Recipients

Document Type : Original Article

Authors

¹ 1-Microbiology and Immunology Department, Faculty of Medicine for Girls, Al Azhar University, Cairo

² 2-Molecular Biology and Virology Department, National Cancer Institute, Cairo University, Cairo, 3- Paediatric Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt

Abstract

Background: Adenovirus (Ad) infections have delayed clearance in paediatric patients. The immune suppression that occurs after hematopoietic stem cell transplantation (HSCT) can reactivate adenovirus, resulting in life-

to assess adenovirus infection in recipients of bone marrow transplantation and to find out if there is an association between adenovirus infection and the occurrence of graft versus host disease (GVHD) in these patients. Patients and methods: The study was conducted on 30 pediatric patients admitted to Nasser institute, for bone marrow transplantation. Serum and stool samples were collected one day prior to bone marrow transplantation, and every one or two weeks afterwards till the patient completed 100 days after HSCT. The adenoviral DNA was monitored in the patient‟s serum and stool samples by quantitative real time polymerase chain reaction (qPCR). The stool samples that tested positive for the presence of adenovirus were processed by cell culture technique for isolation of the virus. Results: Adenoviral DNA was detected in the fecal samples of 11 out of 30 patients (36.6% of cases); the viral load ranged from 1.2 X 103 copies/gram, to 8.4 X 107 copies per gram, two patients had 2 positive stool samples with rising titer indicating the reactivation of the adenovirus. The adenoviral DNA was detected in the serum samples of only two patients (6.6% of cases), with a low titer, one of them was only 500 copies/ml and the other one was 1.6 X 104 copies /ml. The remaining serum samples of the patients who shed the adenovirus in their stool were all negative for adenoviral DNA. These two patients, who had Ad DNA in their serum, had no adenoviral shedding in their stool. The adenovirus reactivation
was not associated with increased risk of developing GVHD, diarrhea or CMV reactivation.
Conclusion: although the adenovirus was shed in the stool of 9 patients, the viral shedding was not associated with increased risk of developing GVHD, diarrhea or CMV reactivation.

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