Shan S, Jia J D
Liver Research Center, Beijing Friendship Hospital, Capital Medical University; Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis; National Clinical Research Center for Digestive Diseases; Beijing 100050, China.
Zhonghua Gan Zang Bing Za Zhi. 2022 May 20;30(5):470-472. doi: 10.3760/cma.j.cn501113-20220429.
Adenovirus infection can occur in all regions or countries of the world, with no obvious seasonality, but pandemics mostly occur in winter or early spring. Adenovirus infection is self-limited among immunocompetent host with supportive care, however fatal infection can occur among immunocompromised patients, mainly affecting respiratory, gastrointestinal tract and adjunctiva and very rarely causing hepatitis, cholecystitis, pancreatitis, hemorrhagic cystitis, myocarditis, meningitis or encephalitis. Adenovirus hepatitis mainly occur in malignant tumors or organ transplantation patients, but acute severe hepatitis can occur even in immunocompetent children or adults. On 5 April 2022, WHO was notified of 10 cases of severe acute hepatitis of unknown etiology in children. As of 21 April 2022, at least 169 cases of acute hepatitis of unknown origin have been reported from 12 countries (including 11 WHO European Region countries and the United States). Adenovirus has been detected in at least 74 cases; SARS-CoV-2 was identified in 20 cases of those that were tested. Furthermore, 19 were detected with a SARS-CoV-2 and adenovirus co-infection. At present, the etiology has not been fully elucidated. The leading hypotheses center around adenovirus, and the relationship with SARS-CoV-2 needs to be further ruled out.
腺病毒感染可发生在世界所有地区或国家，无明显季节性，但大流行大多发生在冬季或早春。在免疫功能正常的宿主中，腺病毒感染为自限性，给予支持性治疗即可，然而在免疫功能低下的患者中可能发生致命感染，主要影响呼吸道、胃肠道和结膜，很少引起肝炎、胆囊炎、胰腺炎、出血性膀胱炎、心肌炎、脑膜炎或脑炎。腺病毒肝炎主要发生在恶性肿瘤或器官移植患者中，但即使在免疫功能正常的儿童或成人中也可能发生急性重型肝炎。2022年4月5日，世卫组织收到关于儿童不明病因严重急性肝炎10例的通报。截至2022年4月21日，12个国家（包括世卫组织欧洲区域的11个国家和美国）报告了至少169例不明原因急性肝炎病例。至少74例检测出腺病毒；在检测的病例中有20例检出严重急性呼吸综合征冠状病毒2（SARS-CoV-2）。此外，19例检测出SARS-CoV-2和腺病毒合并感染。目前，病因尚未完全阐明。主要假说集中在腺病毒，与SARS-CoV-2的关系有待进一步排除。
