A dedicated specimen (i.e. no other tests to be performed) is required for this assay.
Do not use heparin tubes
Respiratory swab only
The assay is a real-time PCR targeting a highly conserved region of the human adenovirus hexon gene .
Human Adenoviruses are nonenveloped, double stranded DNA viruses, classified into the genus Mastadenovirus, family Adenoviridae. They are further subdivided into seven species termed A to G according to a variety of criteria which previously included serum neutralization and haemagglutination inhibition assays, but are more recently based on genomic and bioinformatic analysis of the whole genome.This speciation in general reflects the cell tropism of the viruses and the resulting diseases and symptoms. Whole genome analysis has detected novel and recombinant human adenoviruses which are now classified as ?types? rather than ?serotypes? and numbered consecutively as discovered.
Adenoviruses have increasingly been shown to play a role in the morbidity and mortality of immunosupressed patients. Disseminated adenovirus disease may occur, typically in recipients of allogenic stem-cell transplantation, paediatric oncology patients, or recipients of solid organ transplants. Infection can present as generalised disease or as pneumonia, hepatitis, encephalitis, hemorrhagic cystitis or gastroenteritis. Once established, adenovirus disease is difficult to treat and available therapeutic agents are toxic. Strategies for predicting disseminated disease are therefore important in allowing early preemptive treatment.
LabPlus Virology offers the following categories of tests.
1. Detection of generic adenovirus in nasopharyngeal washings (NPA). This is a semi-quantitative test and is routinely included in the viral respiratory panel (RPAN).
2. Detection of adenovirus 40/41 in stool samples. Species F and G adenoviruses are causally associated with diarrhoea, particularly in pediatric patients.
3. Quantitative detection of generic adenovirus in plasma samples. Prediction of disseminated adenovirus disease in immunocompromised patients is most accurately achieved by monitoring of adenovirus load in plasma.
4. Quantitative detection of generic adenovirus in stool samples. In some instances, warning of disseminated adenovirus infection can be detected significantly earlier (11 days) in NPA or stool samples. Requests for stool sample monitoring MUST specify generic adenovirus testing, not 40/41.
5.
Detection of adenovirus in swabs eg eye swabs or in tissue biopsies eg of affected organs.
References.
1. Thomas L. 2014. Adenovirus infections in Immunocompetent and Immunocompromised Patients. Clinical Microbiology Reviews 27:441-462.
2. Heim A, Ebnet C, Harste G, Pring-?kerblom P . 2003 Rapid and Quantitative Detection of Human Adenovirus DNA by Real-Time PCR. J Med Virol 70:228-239.
3. Lindemans CA, Leen AM, Boelens JJ. 2010. How I treat adenovirus in hematopoietic stem cell transplant recipients. Blood. 116:5476-5485.
For further information contact the laboratory (contact via Lablink: 22000 or (09) 307-8995 or 0800 522 7587) ,or:
the Virology team
virology@adhb.govt.nz