Quantitative Real-Time Polymerase Chain Reaction for Detection of Adenovirus after T Cell–Replete Hematopoietic Cell Transplantation: Viral Load as a Marker for Invasive Disease (original) (raw)

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Program in Infectious Diseases, Fred Hutchinson Cancer Research Center, and Departments of Laboratory

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Seattle

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Program in Infectious Diseases, Fred Hutchinson Cancer Research Center, and Departments of Laboratory

,

Seattle

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,

1

Program in Infectious Diseases, Fred Hutchinson Cancer Research Center, and Departments of Laboratory

,

Seattle

Search for other works by this author on:

,

1

Program in Infectious Diseases, Fred Hutchinson Cancer Research Center, and Departments of Laboratory

,

Seattle

Search for other works by this author on:

,

1

Program in Infectious Diseases, Fred Hutchinson Cancer Research Center, and Departments of Laboratory

,

Seattle

Search for other works by this author on:

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Program in Infectious Diseases, Fred Hutchinson Cancer Research Center, and Departments of Laboratory

,

Seattle

2

Laboratory Medicine

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Seattle

4

Pathology, University of Washington

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Seattle

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Program in Infectious Diseases, Fred Hutchinson Cancer Research Center, and Departments of Laboratory

,

Seattle

2

Laboratory Medicine

,

Seattle

3

Medicine, and Pathology

,

Seattle

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Program in Infectious Diseases, Fred Hutchinson Cancer Research Center, and Departments of Laboratory

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Seattle

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Medicine, and Pathology

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Seattle

Reprints or correspondence: Dr. Michael Boeckh, Fred Hutchinson Cancer Research Center, Program in Infectious Diseases, 1110 Fairview Ave. N. D3-100, PO Box 19024, Seattle, WA 98109-1024 (mboeckh@fhcrc.org).

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Published:

15 October 2007

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Veronique Erard, Meei-Li Huang, James Ferrenberg, Long Nguy, Terry L Stevens Ayers, Robert C. Hackman, Lawrence Corey, Michael Boeckh, Quantitative Real-Time Polymerase Chain Reaction for Detection of Adenovirus after T Cell–Replete Hematopoietic Cell Transplantation: Viral Load as a Marker for Invasive Disease, Clinical Infectious Diseases, Volume 45, Issue 8, 15 October 2007, Pages 958–965, https://doi.org/10.1086/521851
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Abstract

Background. The value of adenovirus plasma DNA detection as an indicator for adenovirus disease is unknown in the context of T cell–replete hematopoietic cell transplantation, of which adenovirus disease is an uncommon but serious complication.

Methods. Three groups of 62 T cell–replete hematopoietic cell transplant recipients were selected and tested for adenovirus in plasma by polymerase chain reaction.

Results. Adenovirus was detected in 21 (87.5%) of 24 patients with proven adenovirus disease (group 1), in 4 (21%) of 19 patients who shed adenovirus (group 2), and in 1 (10.5%) of 19 uninfected control patients. The maximum viral load was significantly higher in group 1 (median maximum viral load, 6.3 × 106 copies/mL; range, 0 to 1.0 × 109 copies/mL) than in group 2 (median maximum viral load, 0 copies/mL; range, 0 to 1.7 × 108 copies/mL; P < .001) and in group 3 (median maximum viral load, 0 copies/mL; range 0–40 copies/mL; P < .001). All patients in group 2 who developed adenoviremia had symptoms compatible with adenovirus disease (i.e., possible disease). A minimal plasma viral load of 103 copies/mL was detected in all patients with proven or possible disease. Adenoviremia was detectable at a median of 19.5 days (range, 8–48 days) and 24 days (range, 9–41 days) before death for patients with proven and possible adenovirus disease, respectively.

Conclusion. Sustained or high-level adenoviremia appears to be a specific and sensitive indicator of adenovirus disease after T cell–replete hematopoietic cell transplantation. In the context of low prevalence of adenovirus disease, the use of polymerase chain reaction of plasma specimens to detect virus might be a valuable tool to identify and treat patients at risk for viral invasive disease.

© 2007 of the Infectious Diseases Society of America

Topic:

• polymerase chain reaction
• adenoviruses
• hematopoietic stem cell transplantation
• dna
• plasma
• t-lymphocytes
• viral load result

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