Identification of a novel intertypic recombinant species D human adenovirus in a pediatric stem cell transplant recipient

J Clin Virol. 2014 Dec;61(4):496-502. doi: 10.1016/j.jcv.2014.09.009. Epub 2014 Sep 28.


Background: Human adenoviruses (HAdV) are known opportunistic pathogens in hematopoietic stem cell transplant (SCT) recipients. The detection of HAdV infection in children after SCT has been implicated as a determinant of poor outcome but specific associations between HAdV species or individual HAdV types and disease are poorly understood.

Objectives: Characterization of a HAdV-D strain isolated from multiple clinical specimens of an 11-year-old female recipient of a matched unrelated donor peripheral SCT for T-cell lymphoma and case report.

Study design: Archived HAdV PCR-positive plasma, urine, and stool specimens were processed for virus isolation and detailed molecular typing. Complete genomic sequencing was carried out on 2 isolates.

Results: The patient tested positive for HAdV DNA by real-time PCR of a stool specimen at 44 days after initiation of a SCT conditioning regimen. In the subsequent 3 months, HAdV was detected in plasma, urine and stool specimens in association with symptoms of gastroenteritis and hemorrhagic cystitis. A novel HAdV-D with a HAdV20-like hexon gene was isolated from both urine and stool specimens. All isolates yielded identical restriction profiles with endonucleases BamHI, BglII, BstEII, HindIII, PstI and SmaI. Analysis of 2 complete genomic sequences further identified the virus as a novel intertypic recombinant HAdV-D (P20/H20/F42) closely related to HAdV42.

Conclusions: This case highlights the identification of a previously unknown HAdV-D from an immunocompromised host. In this patient, the course of adenovirus infection is compatible with reactivation of a latent virus or a primary opportunistic infection. Adenoviremia in this patient resolved without definitive adenovirus-directed antiviral therapy.

Keywords: Adenovirus; Genomic sequence; Species D; Transplant.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adenovirus Infections, Human / virology*
  • Adenoviruses, Human / classification*
  • Adenoviruses, Human / genetics
  • Adenoviruses, Human / isolation & purification*
  • Child
  • DNA, Viral / chemistry
  • DNA, Viral / genetics
  • Feces / virology
  • Female
  • Genome, Viral
  • Humans
  • Molecular Sequence Data
  • Plasma / virology
  • Real-Time Polymerase Chain Reaction
  • Sequence Analysis, DNA
  • Stem Cell Transplantation / adverse effects*
  • Transplant Recipients*
  • Urine / virology


  • DNA, Viral

Associated data

  • GENBANK/KJ626291
  • GENBANK/KJ626292