Laboratoire de Virologie, CHU Angers, Angers, France.
Univ Angers, HIFIH, SFR ICAT, Angers, France.
J Med Virol. 2023 Jul;95(7):e28922. doi: 10.1002/jmv.28922.
Human adenoviruses (HAdVs) of the F species are commonly responsible for acute gastroenteritis. A few cases of systemic infections have been described in adults or children who have received a hematopoietic stem cell transplant (HSCT), but with no report of liver cytolysis. Since January 2022, several countries have reported an increase in cases of acute hepatitis of unknown cause in children. Adenovirus species F type 41 (HAdV-F41) infection was predominantly identified. The objective of this study is to describe HAdV-F41 infections diagnosed since January 2022 in adult HSCT recipients in two French hospitals. All four patients had diarrhea and liver cytolysis at the time of diagnosis of infection. HAdV viremia was observed in three patients (#1, #3, and #4), but no disseminated disease was reported. HAdV whole genome sequencing and metagenomics characterization were performed on stool and blood samples. The complete HAdV-F41 genome sequence was obtained for three patients and phylogenetic analysis showed that the strains consisted of similar lineage (2b). We did not identify any new HAdV-F41 strains. Metagenomics analysis found adeno-associated virus 2 and torque-teno virus infection in patient #1 and Epstein-Barr virus in patient #4. This is the first case series reporting liver cytolysis during HAdV-F41 infection in adult HSCT patients.
人类腺病毒（HAdV）F 型通常是急性肠胃炎的罪魁祸首。在接受造血干细胞移植（HSCT）的成人或儿童中，有少数全身感染的病例被描述过，但没有肝细胞溶解的报告。自 2022 年 1 月以来，几个国家报告了儿童不明原因急性肝炎病例的增加。主要鉴定出腺病毒 F 型 41 型（HAdV-F41）感染。本研究的目的是描述 2022 年 1 月以来在法国两家医院接受 HSCT 的成年患者中诊断出的 HAdV-F41 感染。所有 4 名患者在感染诊断时均出现腹泻和肝细胞溶解。在 3 名患者（#1、#3 和#4）中观察到 HAdV 血症，但未报告弥散性疾病。对粪便和血液样本进行了 HAdV 全基因组测序和宏基因组特征分析。获得了 3 名患者的完整 HAdV-F41 基因组序列，系统发育分析表明，这些菌株属于相似的谱系（2b）。我们没有发现任何新的 HAdV-F41 株。宏基因组分析发现患者 #1 感染腺伴随病毒 2 和 torque-teno 病毒，患者 #4 感染 Epstein-Barr 病毒。这是首例报告在接受 HSCT 的成年患者中，HAdV-F41 感染期间出现肝细胞溶解的病例系列。
