Abstract
Purpose: To describe the demographics, clinical manifestations, treatment and outcomes of patients with human adenovirus (HAdV) hepatitis. Methods: A case of fulminant HAdV hepatitis in a patient with chronic lymphocytic leukemia receiving rituximab and fludarabine is described. We conducted a comprehensive review of the English-language literature through May, 2012 in search of definite cases of HAdV hepatitis. Results: Eighty-nine cases were reviewed. Forty-three (48%) were liver transplant recipients, 19 (21%) were bone marrow transplant recipients, 11 (12%) had received chemotherapy, five (6%) had severe combined immunodeficiency, four (4%) were HIV infected, two had heart transplantation, and two were kidney transplant recipients. Ninety percent (46/51) of patients presented within 6 months following transplantation. Fever was the most common initial symptom. Abdominal CT scan revealed hypodense lesions in eight of nine patients. Diagnosis was made by liver biopsy in 43 (48%), and on autopsy in 46 (52%). The HAdV was isolated at other sites in 54 cases. Only 24 of 89 patients (27%) survived: 16 whose immunosuppression was reduced, six with liver re-transplantation, and two who received cidofovir and intravenous immunoglobulin. Conclusion: HAdV hepatitis can manifest as a fulminant illness in immunocompromised hosts. Definitive diagnosis requires liver biopsy. Early consideration of a viral etiology, reduction in immunosuppression, and liver transplantation can be potentially life-saving.
Original language | English (US) |
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Pages (from-to) | 105-111 |
Number of pages | 7 |
Journal | Infection |
Volume | 42 |
Issue number | 1 |
DOIs | |
State | Published - Feb 2014 |
Keywords
- Acute liver failure
- Adenovirus
- Hepatic failure
- Hepatitis
- Rituximab
ASJC Scopus subject areas
- Microbiology (medical)
- Infectious Diseases