Adenovirus Infections and Clinical Management

Adenoviruses are non-enveloped, double-stranded DNA viruses that cause a spectrum of diseases ranging from mild respiratory illness and conjunctivitis to severe pneumonia, gastroenteritis and, in rare cases, hepatitis. Transmission occurs via respiratory droplets, faecal–oral routes and contact with contaminated surfaces. Clinical presentation varies by serotype, host age and immune status, with immunocompromised patients and young children at greater risk of severe outcomes. Diagnosis relies on nucleic acid amplification, antigen detection and serotyping. Management is largely supportive, including hydration, oxygen supplementation and, when appropriate, ventilatory support. Antiviral therapy with cidofovir or brincidofovir may be considered in severe or disseminated cases, particularly in immunosuppressed individuals, although efficacy data remain limited. Vaccine development has focused on military populations for specific serotypes. Recent efforts aim to refine risk stratification, explore targeted antiviral agents and develop broadly reactive vaccines. Integration of genomic surveillance with clinical data is enhancing understanding of serotype emergence and guiding therapeutic strategies on a global scale.

Research from Nature Portfolio

Recent studies have identified an association between adeno-associated virus 2 (AAV2) infection and a surge in acute paediatric hepatitis of unknown cause. Detailed sequencing and immunogenetic analyses revealed that co-infection with human adenovirus likely provides the helper function required for AAV2 replication in hepatocytes, while certain HLA class II alleles confer heightened susceptibility to liver injury. In parallel, genomic studies of species C adenoviruses have elucidated patterns of homologous recombination in early gene regions and capsid loci, demonstrating how genetic exchange drives diversification and may influence virulence. These insights underpin ongoing efforts to link viral evolution to clinical phenotypes and to prioritise serotypes for diagnostic panels.

Adenovirus Infections and Clinical Management publication trend

The graph below shows the total number of articles in adenovirus infections and clinical management across all publications each year (not limited to Nature Index journals).

Technical terms

Adenovirus: A group of non-enveloped, double-stranded DNA viruses causing respiratory, ocular and gastrointestinal infections.

Adeno-associated virus 2 (AAV2): A dependoparvovirus that requires a helper virus such as adenovirus for replication; implicated in paediatric hepatitis.

Viraemia: The presence of virus particles or viral nucleic acid in the bloodstream, indicating systemic infection.

Monoclonal antibody: A laboratory-derived antibody targeting a single viral epitope, used for passive immunotherapy.

Serotype: A distinct virus subtype defined by antigenic properties of its capsid proteins, influencing tissue tropism and immunity.

References

1. Adeno-associated virus 2 infection in children with non-A–E hepatitis. Nature (2023).
2. Paediatric acute hepatitis of unknown aetiology: a national investigation and adenoviraemia case-control study in the UK. The Lancet Child & Adolescent Health (2023).
3. Neutralizing monoclonal antibodies protect against human adenovirus type 55 infection in transgenic mice and tree shrews. Emerging Microbes & Infections (2024).
4. Molecular Evolution of Human Adenovirus (HAdV) Species C. Scientific Reports (2019).