Adenovirus—A Deadly Disease in the Solid Organ Transplant Population: Risk Factors and Outcomes

The importance of adenoviruses (AdV) in the immunocompromised population has been more recognized in recent decades. We aimed to assess the risk factors and outcomes associated with AdV in solid organ transplant recipients. This was a retrospective cohort study of solid organ transplant recipients who tested positive for AdV between January 1, 2004, and March 12, 2014. The subjects were divided in 2 groups: AdV asymptomatic infection and AdV disease. The characteristics and outcomes of the groups were compared using Wilcoxon rank-sum and Fisher exact tests; logistic regression was performed to evaluate risk factors. A total of 125 patients were included with a mean (SD) age of 9.79 years (16.54); 49.6% were male, and 20.8% had AdV disease. No significant risk factors were found for AdV disease by univariate analyses. Comparing patients with disease and with asymptomatic infection, rejections during the first year after testing positive for AdV were 7 (26.92%) vs 17 (17.17%); mortality at 1 year post-transplantation was 26.92% vs 6.06% (P = .006), respectively, and at 1 year after testing positive for AdV was 38.46% vs 11.11% (P = .002), respectively. No independent risk factor for AdV disease was identified, but patients with AdV disease had a significantly higher mortality compared with those with asymptomatic infection. •Patients with adenovirus (AdV) disease have higher mortality compared with patients with asymptomatic AdV infection.•It remains unclear which transplant recipients are at higher risk for AdV disease and might benefit from preventive therapy.