Clearance of adenoviral hepatitis with ribavirin therapy in a pediatric liver transplant recipient.

Adenovirus (AdV) infections, localized or disseminated, are being increasingly recognized in immunocompromised patients including bone marrow and solid organ transplant recipients and HIV-1-infected patients. AdV infection in pediatric liver transplant recipients may present as hepatitis in the transplanted liver and is usually diagnosed by immunohistochemical staining of liver tissue. Recommended therapies have included withdrawal of immunosuppressive agents and in some cases intravenous ribavirin. There has been no previous report of successful clearance of AdV hepatitis with ribavirin in a pediatric liver transplant recipient. We report the clearance of AdV hepatitis in a child who received two liver transplants, developed AdV hepatitis and was successfully treated with intravenous ribavirin. Diagnosis and monitoring of her AdV infection were enhanced through the use of a newly described polymerase chain reaction for AdV.

[1]  D. Milligan,et al.  Fulminant adenovirus hepatitis following unrelated bone marrow transplantation: failure of intravenous ribavirin therapy , 1999, Bone Marrow Transplantation.

[2]  J. Ticehurst,et al.  PCR Method for Detection of Adenovirus in Urine of Healthy and Human Immunodeficiency Virus-Infected Individuals , 1998, Journal of Clinical Microbiology.

[3]  B. Portmann,et al.  A randomized study comparing ribavirin and interferon alfa monotherapy for hepatitis C recurrence after liver transplantation , 1998, Hepatology.

[4]  J. Moreb,et al.  Failure of intravenous ribavirin in the treatment of invasive adenovirus infection following allogeneic bone marrow transplantation: a case report. , 1998, The Journal of infection.

[5]  M. Kawakami,et al.  Vidarabine therapy for virus-associated cystitis after allogeneic bone marrow transplantation , 1997, Bone Marrow Transplantation.

[6]  E. Gutierrez,et al.  Detection of adenovirus DNA in peripheral blood mononuclear cells by polymerase chain reaction assay , 1997, Journal of medical virology.

[7]  M. Bergin,et al.  Intravenous ribavirin therapy for disseminated adenovirus infection. , 1995, The Pediatric infectious disease journal.

[8]  S. Khoo,et al.  Adenovirus infections in human immunodeficiency virus-positive patients: clinical features and molecular epidemiology. , 1995, The Journal of infectious diseases.

[9]  M. Horowitz,et al.  Increasing incidence of adenovirus disease in bone marrow transplant recipients. , 1994, The Journal of infectious diseases.

[10]  J. Hierholzer.  Adenoviruses in the immunocompromised host , 1992, Clinical Microbiology Reviews.

[11]  W. Cassano.  Intravenous ribavirin therapy for adenovirus cystitis after allogeneic bone marrow transplantation. , 1991, Bone marrow transplantation.

[12]  T. Starzl,et al.  Adenoviral infections in pediatric liver transplant recipients. , 1987, JAMA.

[13]  J. Horváth,et al.  Group C adenovirus DNA sequences in human lymphoid cells , 1986, Journal of virology.

[14]  R. Dagan,et al.  Severe diffuse adenovirus 7a pneumonia in a child with combined immunodeficiency: possible therapeutic effect of human immune serum globulin containing specific neutralizing antibody , 1984, Pediatric infectious disease.

[15]  R. Postlethwaite.  Liver Damage Induced in Mice by Human Adenovirus Type 5 , 1973 .

[16]  H. Pereira,et al.  Fatal Infection of New-Born Hamsters by an Adenovirus of Human Origin , 1962, Nature.

[17]  E. Sokal,et al.  Acute adenovirus hepatitis in liver transplant recipients. , 1992, The Journal of pediatrics.

[18]  T. Starzl,et al.  Adenovirus infection in pediatric liver transplant recipients. , 1992, The Journal of infectious diseases.

[19]  D. V. van Thiel,et al.  Serological studies of adenoviral hepatitis following pediatric liver transplantation. , 1990, Transplantation proceedings.