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Epidemiology and clinical manifestations of adenovirus infection

Phyllis Flomenberg, MD
Tsoline Kojaoghlanian, MD
Section Editors
Martin S Hirsch, MD
Sheldon L Kaplan, MD
Deputy Editor
Sheila Bond, MD


Adenoviruses are a family of viruses that are an important cause of febrile illnesses in young children. They are most frequently associated with upper respiratory tract syndromes, such as pharyngitis or coryza, but can also cause pneumonia. Less commonly, adenoviruses cause gastrointestinal, ophthalmologic, genitourinary, and neurologic diseases. Most adenoviral diseases are self-limiting, although fatal infections can occur in immunocompromised hosts and occasionally in healthy children and adults.

In addition to their importance as infectious agents, adenoviruses are being studied intensively as vectors to deliver foreign genes both for gene therapy and for immunization against tumors and certain infections, such as HIV-1 and malaria. (See "Adenovirus pathogenesis and vector applications".)

The epidemiology and clinical manifestations of adenovirus infections will be reviewed here. Issues relating to pathogenesis, diagnosis, and treatment are discussed separately. (See "Diagnosis, treatment, and prevention of adenovirus infection".)


Adenoviruses have a double-stranded DNA genome of approximately 35 kb surrounded by a nonenveloped icosahedron with fiber-like projections from each of the 12 vertices. The fiber protein is attached noncovalently to the icosahedron by a pentameric polypeptide named penton base. The fiber protein from most adenoviruses, except subgroup B, binds to the cellular receptor CAR (coxsackie-adenovirus receptor), which also binds coxsackie B virus [1]. Group B adenoviruses have been shown to bind to CD46, a complement-related protein [2,3]. The penton base mediates internalization via interaction with specific cellular integrins [4].

The major surface protein of the virion is the trimeric polypeptide hexon. Group-reactive antigenic determinants are present on the hexon proteins from all human adenoviruses. Serotype-specific neutralizing epitopes are present both on the fiber and hexon proteins with minor sites on the penton base. In addition, many adenoviruses hemagglutinate rat or rhesus red blood cells; this property is related to the fiber protein.

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Literature review current through: Nov 2017. | This topic last updated: Oct 24, 2017.
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