Citation: Xingui Tian, Xiao Li, Shuyan Qiu, Rong Zhou, Wenkuan Liu. Abnormal liver function in children hospitalized with acute respiratory infection of adenoviruses: a retrospective study .VIROLOGICA SINICA, 2023, 38(5) : 735-740.  http://dx.doi.org/10.1016/j.virs.2023.07.007

Abnormal liver function in children hospitalized with acute respiratory infection of adenoviruses: a retrospective study

  • Human adenoviruses (HAdVs) can cause acute hepatitis in immunocompromised patients. However, it is unclear whether HAdVs are contributors to hepatitis in immunocompetent children. In this study, the liver function test (LFT) results were retrospectively analyzed among children hospitalized (age <14 years) between January 2016 and October 2019 for acute respiratory infection caused by adenoviruses. Alanine transaminase (ALT) and aspartate aminotransferase (AST) levels were elevated in 7.74% and 46.89% of patients, respectively. All patients with >2 folds of the upper limit of ALT or AST levels were infected with HAdV-7 or HAdV-55. Significantly higher levels of ALT, AST, γ-glutamyl transpeptidase (γ-GT), and lower albumin levels were observed in the HAdV-7 infection group than in the HAdV-3 infection group. HAdV-55 infection led to significantly higher γ-GT, total bilirubin, and direct bilirubin levels than the other infection types. The records of four patients with serial monitoring of the LFT results were further analyzed. Multiple indicators remained abnormal during the entire hospitalization in these patients. These results indicate that HAdV infection is often accompanied by abnormal liver function, and HAdV-7 and HAdV-55 might be under-recognized contributors to hepatitis among children.

  • 加载中
  • 10.1016j.virs.2023.07.007-ESM.docx
    1. Alwen J (1973) Antibodies to adenovirus in patients with infectious hepatitis. Lancet 1:1452-1453

    2. Baker JM, Buchfellner M, Britt W, Sanchez V, Potter JL, Ingram LA, Shiau H, Gutierrez Sanchez LH, Saaybi S, Kelly D, Lu X, Vega EM, Ayers-Millsap S, Willeford WG, Rassaei N, Bullock H, Reagan-Steiner S, Martin A, Moulton EA, Lamson DM, St George K, Parashar UD, Hall AJ, MacNeil A, Tate JE, Kirking HL (2022) Acute Hepatitis and Adenovirus Infection Among Children-Alabama, October 2021-February 2022. MMWR Morb Mortal Wkly Rep 71:638-640

    3. Chen Q, Liu J, Liang W, Chen Y, Dou M, Liu Z, Chen Y, Zheng Z, Zhu B, Lin Y (2021) Clinical Features, Replication Competence, and Innate Immune Responses of Human Adenovirus Type 7 Infection. J Infect Dis 223:1390-1399

    4. Chen Y, Lin T, Wang CB, Liang WL, Lian GW, Zanin M, Wong SS, Tian XG, Zhong JY, Zhang YY, Xie JH, Zheng LL, Chen FY, Dang R, Zhao MQ, Yang YY, Zhou R, Zhu B (2022) Human adenovirus (HAdV) infection in children with acute respiratory tract infections in Guangzhou, China, 2010-2021:a molecular epidemiology study. World J Pediatr 18:545-552

    5. Fu Y, Tang Z, Ye Z, Mo S, Tian X, Ni K, Ren L, Liu E, Zang N (2019) Human adenovirus type 7 infection causes a more severe disease than type 3. BMC Infect Dis 19:36

    6. Gao Y, Wang L, Wang L, Lu F (2022) Severe acute hepatitis in children with unknown aetiology, etiology analysis and the next action. Virol Sin 37:778-782

    7. Ho A, Orton R, Tayler R, Asamaphan P, Herder V, Davis C, Tong L, Smollett K, Manali M, Allan J, Rawlik K, McDonald SE, Vink E, Pollock L, Gannon L, Evans C, McMenamin J, Roy K, Marsh K, Divala T, Holden MTG, Lockhart M, Yirrell D, Currie S, O'Leary M, Henderson D, Shepherd SJ, Jackson C, Gunson R, MacLean A, McInnes N, Bradley-Stewart A, Battle R, Hollenbach J, Henderson P, Odam M, Chikowore P, Oosthuyzen W, Chand M, Hamilton MS, Estrada-Rivadeneyra D, Levin M, Avramidis N, Pairo-Castineira E, Vitart V, Wilkie C, consortium D, investigators IC, Palmarini M, Ray S, Robertson DL, da Silva Filipe A, Willett BJ, Breuer J, Semple MG, Turner D, Baillie JK, Thomson EC (2023) Adeno-associated virus 2 infection in children with non-A-E hepatitis. Nature 10.1038/s41586-023-05948-2

    8. Khalifa A, Andreias L, Velpari S (2022) Adenovirus Hepatitis in Immunocompetent Adults. J Investig Med High Impact Case Rep 10:23247096221079192

    9. Li X, Zhou Z, Liu W, Fan Y, Luo Y, Li K, Zheng Z, Tian X, Zhou R (2021) Chinese tree shrew:a permissive model for in vitro and in vivo replication of human adenovirus species B. Emerg Microbes Infect 10:424-438

    10. Liu W, Qiu S, Zhang L, Wu H, Tian X, Li X, Xu D, Dai J, Gu S, Liu Q, Chen D, Zhou R (2022) Analysis of severe human adenovirus infection outbreak in Guangdong Province, southern China in 2019. Virol Sin 10.1016/j.virs.2022.01.010

    11. Matoq A, Salahuddin A (2016) Acute Hepatitis and Pancytopenia in Healthy Infant with Adenovirus. Case Rep Pediatr 2016:8648190

    12. Morfopoulou S, Buddle S, Montaguth OET, Atkinson L, Guerra-Assuncao JA, Marjaneh MM, Chiozzi RZ, Storey N, Campos L, Hutchinson JC, Counsell JR, Pollara G, Roy S, Venturini C, Antinao Diaz JF, Siam A, Tappouni LJ, Asgarian Z, Ng J, Hanlon KS, Lennon A, McArdle A, Czap A, Rosenheim J, Andrade C, Anderson G, Lee JCD, Williams R, Williams CA, Tutill H, Bayzid N, Bernal LMM, Macpherson H, Montgomery KA, Moore C, Templeton K, Neill C, Holden M, Gunson R, Shepherd SJ, Shah P, Cooray S, Voice M, Steele M, Fink C, Whittaker TE, Santilli G, Gissen P, Kaufer BB, Reich J, Andreani J, Simmonds P, Alrabiah DK, Hereza SC, Chikowore P, Odam M, Rampling T, Houlihan C, Hoschler K, Talts T, Celma C, Gonzalez S, Gallagher E, Simmons R, Watson C, Mandal S, Zambon M, Chand M, Hatcher J, De S, Baillie K, Semple MG, Consortium D, Consortium P, Consortium I, Martin J, Ushiro-Lumb I, Noursadeghi M, Deheragoda M, Hadzic N, Grammatikopoulos T, Brown R, Kelgeri C, Thalassinos K, Waddington SN, Jacques TS, Thomson E, Levin M, Brown JR, Breuer J (2023) Genomic investigations of unexplained acute hepatitis in children. Nature 10.1038/s41586-023-06003-w

    13. Munoz FM, Piedra PA, Demmler GJ (1998) Disseminated adenovirus disease in immunocompromised and immunocompetent children. Clin Infect Dis 27:1194-1200

    14. Onda Y, Kanda J, Sakamoto S, Okada M, Anzai N, Umadome H, Tashima M, Haga H, Watanabe C, Hanaoka N, Fujimoto T, Takaori-Kondo A (2021) Detection of adenovirus hepatitis and acute liver failure in allogeneic hematopoietic stem cell transplant patients. Transpl Infect Dis 23:e13496

    15. Ozbay Hosnut F, Canan O, Ozcay F, Bilezikci B (2008) Adenovirus infection as possible cause of acute liver failure in a healthy child:a case report. Turk J Gastroenterol 19:281-283

    16. Peled N, Nakar C, Huberman H, Scherf E, Samra Z, Finkelstein Y, Hoffer V, Garty BZ (2004) Adenovirus infection in hospitalized immunocompetent children. Clin Pediatr (Phila) 43:223-229

    17. Servellita V, Gonzalez AS, Lamson DM, Foresythe A, Huh HJ, Bazinet AL, Bergman NH, Bull RL, Garcia KY, Goodrich JS, Lovett SP, Parker K, Radune D, Hatada A, Pan CY, Rizzo K, Bertumen JB, Morales C, Oluniyi PE, Nguyen J, Tan J, Stryke D, Jaber R, Leslie MT, Lyons Z, Hedman HD, Parashar U, Sullivan M, Wroblewski K, Oberste MS, Tate JE, Baker JM, Sugerman D, Potts C, Lu X, Chhabra P, Pediatric Hepatitis of Unknown Etiology Working G, Ingram LA, Shiau H, Britt W, Sanchez LHG, Ciric C, Rostad CA, Vinje J, Kirking HL, Wadford DA, Raborn RT, St George K, Chiu CY (2023) Adeno-associated virus type 2 in US children with acute severe hepatitis. Nature 10.1038/s41586-023-05949-1

    18. WHO (2022[Accessed 2022 June 24]) Multi-Country-Acute, severe hepatitis of unknown origin in children. Available from:https://wwwwhoint/emergencies/disease-outbreak-news/item/2022-DON394

    19. Zhang D, Chen Y, Shi T, Fan H, Tian X, Zhou R, Huang L, Yang D, Lu G (2022) Severe pneumonia caused by human adenovirus type 55 in children. Front Pediatr 10:1002052

  • 加载中

Article Metrics

Article views(2256) PDF downloads(4) Cited by()

Related
Proportional views

    Abnormal liver function in children hospitalized with acute respiratory infection of adenoviruses: a retrospective study

      Corresponding author: Xingui Tian, xgtian@gzhmu.edu.cn
      Corresponding author: Rong Zhou, zhourong@gird.cn
      Corresponding author: Wenkuan Liu, ahlwk2000-2004@163.com
    • State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, 510182, China

    Abstract: Human adenoviruses (HAdVs) can cause acute hepatitis in immunocompromised patients. However, it is unclear whether HAdVs are contributors to hepatitis in immunocompetent children. In this study, the liver function test (LFT) results were retrospectively analyzed among children hospitalized (age <14 years) between January 2016 and October 2019 for acute respiratory infection caused by adenoviruses. Alanine transaminase (ALT) and aspartate aminotransferase (AST) levels were elevated in 7.74% and 46.89% of patients, respectively. All patients with >2 folds of the upper limit of ALT or AST levels were infected with HAdV-7 or HAdV-55. Significantly higher levels of ALT, AST, γ-glutamyl transpeptidase (γ-GT), and lower albumin levels were observed in the HAdV-7 infection group than in the HAdV-3 infection group. HAdV-55 infection led to significantly higher γ-GT, total bilirubin, and direct bilirubin levels than the other infection types. The records of four patients with serial monitoring of the LFT results were further analyzed. Multiple indicators remained abnormal during the entire hospitalization in these patients. These results indicate that HAdV infection is often accompanied by abnormal liver function, and HAdV-7 and HAdV-55 might be under-recognized contributors to hepatitis among children.

    Reference (19) Relative (20)

    目录

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return