Disseminated adenovirus disease in immunocompromised and immunocompetent children
Disseminated adenovirus disease in immunocompromised and immunocompetent children
复制标题
DOI：
10.1086/514978
复制
发表时间：
1998-11-01
影响因子：
11.8
通讯作者：
Demmler, GJ
中科院分区：
文献类型：
--
作者：
Munoz, FM;Piedra, PA;Demmler, GJ
对1990-1996年德克萨斯儿童医院腺病毒感染进行回顾性分析，以评价儿童播散性腺病毒病（DAD）的流行病学、临床病程、治疗和结局。440例腺病毒感染患者中有11例（2.5%）发生多器官受累的DAD。11例患者中有6例（54%）免疫功能低下，5例（45%）免疫功能正常。免疫缺陷者的死亡率为83%，免疫正常者为60%，总体为73%。在接受免疫球蛋白联合或不联合抗病毒药物治疗的7例患者中，2例（28%）死于DAD，4例未接受治疗的患者中，3例（75%）死于DAD。DAD由特定血清型（3、5和7）引起，在免疫功能正常的儿童中发生在较年轻的年龄。病毒血症和病毒排泄延长在免疫功能低下者中更为常见。两组的临床特征和结局相似。前瞻性研究解决新的抗病毒药物的使用，联合抗病毒治疗和预防策略是必要的，以确定最佳的治疗方法与DAD患者。
A retrospective review of adenovirus infections at Texas Children's Hospital during 1990-1996 was performed to evaluate the epidemiology, clinical course, management, and outcome of disseminated adenovirus disease (DAD) in children. DAD with multiorgan involvement occurred in 11 (2.5%) of 440 adenovirus-infected patients. Six (54%) of the 11 were immunocompromised and 5 (45%) were immunocompetent. Mortality was 83% among the immunodeficient, 60% in the immunocompetent, and 73% overall. Two (28%) of the 7 patients receiving immunoglobulins with or without antivirals and 3 (75%) of the 4 not treated died of DAD. DAD was caused by particular serotypes (3, 5, and 7) and occurred at a younger age in immunocompetent children. Viremia and prolonged viral excretion were more common in the immunocompromised. Clinical features and outcome were similar in both groups. Prospective studies addressing the use of new antiviral agents, combination antiviral therapy, and preventive strategies are necessary to determine the optimal therapeutic approach for patients with DAD.