Sections

Adenovirus

Medication

Medication Summary

Medical therapy is not indicated in healthy hosts. However, adenoviral keratitis has been treated with early topical steroids to avoid loss of sight; refer to the available ophthalmologic literature for details on the management of adenoviral ophthalmologic infections.

Ribavirin and cidofovir therapy have been used with variable success in immunosuppressed hosts. Anecdotal evidence suggests success against adenoviral infection with combined intravenous ribavirin and pooled human intravenous immunoglobulin. Also anecdotally, intravesical cidofovir has been reported to be successful in persons with adenoviral hemorrhagic cystitis; the latter delivery method may obviate the systemic toxicity of this agent and warrants investigation.^[57]

Weighing the severity of illness, the likelihood of response in a given setting, and the possibility of adverse events, decisions regarding treatment should be individualized at this time. Evidence-based standardized treatment guidelines currently are lacking, and consultation with an infectious diseases clinician is recommended.

Class Summary

These agents inhibit viral DNA and protein synthesis.

Ribavirin (Virazole)

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Inhibits viral replication by inhibiting DNA and RNA synthesis. Antiviral against RSV, influenza virus, herpes simplex virus, and hepatitis C virus. The latter requires adjunctive treatment with interferons.

The likelihood that most adenovirus infections in immunosuppressed hosts are disseminated warrants intravenous rather than inhalational therapy, including in the setting of adenoviral pneumonia.

Cidofovir (Vistide)

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Nucleotide analog that selectively inhibits viral DNA production in CMV and other herpes viruses. Indicated for CMV retinitis.

Class Summary

Decreases incidence of adenovirus outbreaks in military personnel.

Adenovirus vaccine types 4 and 7 live, oral

Live oral vaccine that replicates in intestinal tract and induces immunity in persons with low or no preexisting neutralizing antibodies to adenoviruses types 4 and 7. Indicated for active immunization of military populations aged 17-50 y for prevention of febrile acute respiratory disease caused by adenovirus types 4 and 7.

Questions

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Media Gallery

A virus image from the International Committee on Taxonomy of Viruses, in The Big Picture Book of Viruses, available at http://www.virology.net/Big_Virology/BVDNAadeno.html.
Transmission electron micrograph of adenovirus. Image courtesy of the US Centers for Disease Control and Prevention.
Pseudomembranes and conjunctival inflammation due to adenovirus epidemic keratoconjunctivitis. Courtesy of Steve Tuft, Moorfields Eye Hospital, and Community Eye Health Journal.
Subepithelial infiltrates characteristic of adenoviral keratoconjunctivitis. Courtesy of Wikimedia Commons (author Imrankabirhossain).

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Author

Sandra G Gompf, MD, FACP, FIDSA Professor of Infectious Disease and International Medicine, University of South Florida Morsani College of Medicine; Chief, Infectious Diseases Section, Director, Occupational Health and Infection Control Programs, James A Haley Veterans Hospital

Sandra G Gompf, MD, FACP, FIDSA is a member of the following medical societies: American College of Physicians, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Coauthor(s)

Tuhina Cornelius, MD, MBBS Fellow in Infectious Disease, Florida Department of Health, University of South Florida Morsani College of Medicine

Tuhina Cornelius, MD, MBBS is a member of the following medical societies: American College of Physicians

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Richard B Brown, MD, FACP Chief, Division of Infectious Diseases, Baystate Medical Center; Professor, Department of Internal Medicine, Tufts University School of Medicine

Richard B Brown, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Chest Physicians, American College of Physicians, American Medical Association, American Society for Microbiology, Infectious Diseases Society of America, Massachusetts Medical Society

Disclosure: Nothing to disclose.

Chief Editor

Michael Stuart Bronze, MD David Ross Boyd Professor and Chairman, Department of Medicine, Stewart G Wolf Endowed Chair in Internal Medicine, Department of Medicine, University of Oklahoma Health Science Center; Master of the American College of Physicians; Fellow, Infectious Diseases Society of America; Fellow of the Royal College of Physicians, London

Michael Stuart Bronze, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Medical Association, Association of Professors of Medicine, Infectious Diseases Society of America, Oklahoma State Medical Association, Southern Society for Clinical Investigation

Disclosure: Nothing to disclose.

Additional Contributors

David Hall Shepp, MD Program Director, Fellowship in Infectious Diseases, Department of Medicine, North Shore University Hospital; Associate Professor, New York University School of Medicine

David Hall Shepp, MD is a member of the following medical societies: Infectious Diseases Society of America

Disclosure: Received salary from Gilead Sciences for management position.

Richard Oehler, MD Associate Professor, Department of Internal Medicine, Division of Infectious Diseases and International Medicine, University of South Florida College of Medicine; Director of Clinical Education, Division of Infectious Diseases, Tampa Veterans Affairs Medical Center

Richard Oehler, MD is a member of the following medical societies: American College of Physicians, American Medical Association, Infectious Diseases Society of America, Society for Healthcare Epidemiology of America

Disclosure: Nothing to disclose.

Dhanashree Kelkar, MD Lecturer, Department of Medicine, Dr Vasantrao Pawar Medical College, Maharashtra University of Health Sciences, India

Dhanashree Kelkar, MD is a member of the following medical societies: American Medical Association, American Association of Physicians of Indian Origin

Disclosure: Nothing to disclose.

Adenovirus Medication

Medication Summary

Antivirals

Class Summary

Ribavirin (Virazole)

Ribavirin (Virazole)

Cidofovir (Vistide)

Cidofovir (Vistide)

Vaccines

Class Summary

Adenovirus vaccine types 4 and 7 live, oral

Adenovirus Medication

Medication Summary

Antivirals

Class Summary

Ribavirin (Virazole)

Ribavirin (Virazole)

Cidofovir (Vistide)

Cidofovir (Vistide)

Vaccines

Class Summary

Adenovirus vaccine types 4 and 7 live, oral

References

Tables

Contributor Information and Disclosures

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