One of the early signs of loss of immune control over adenovirus is the fecal shedding of adenovirus following allogeneic hematopoietic stem-cell transplantation (HSTC). The objective of this research is to investigate if serial fecal PCR monitoring could predict the risk and survival outcomes of adenoviremia after HSTC.

The researchers conducted a retrospective cohort study at the Royal Manchester Children’s Hospital, Manchester, UK. The participants included patients who had received their first allogeneic HSTC, and adenovirus was noted in their medical records. The researchers obtained the characteristics of patients and transplants, including adenoviral reactivation and mortality from the medical records of the hospital database. All patients had their blood samples tested every week for adenovirus by PCR before and after transplantation.

Out of 341 patients with a first allogeneic HSCT, 293 patients had adenovirus in fecal samples, and 63 had adenovirus in blood samples. There were no findings of non-relapse mortality with adenovirus in feces alone, but it was increased in patients who developed adenoviremia.

The research concluded that there is a threshold fecal viral load that can predict the risk of adenoviremia. The findings support the development of adenovirus in the gastrointestinal tract before viremia develops.