What is the pathophysiology of adenovirus infections?

Updated: Apr 15, 2021
  • Author: Sandra G Gompf, MD, FACP, FIDSA; Chief Editor: Michael Stuart Bronze, MD  more...
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Adenoviruses are a family of >60 serotypes, divided into seven subgroups or species (A through G). Measuring 70-90 nm, its double-stranded DNA genome is surrounded by a non-enveloped icosahedron capsid with fiber-like projections from each of its 12 vertices. Certain serotypes are associated with distinct clinical manifestations, reflecting preferential infection of the respiratory, gastrointestinal, and urinary tracts and conjunctiva. Serotype-specific clinical manifestations may be partially determined by differences in cell tropism. Adenoviruses are immunogenic and elicit strong innate and adaptive immune responses. Recovery from adenovirus infection is associated with the development of serotype-specific neutralizing antibodies.

Upon infection with adenovirus, one of three different interactions with the cells may occur.

The first is lytic infection, which occurs when an adenovirus enters human epithelial cells and continues through an entire replication cycle, which results in cytolysis, cytokine production, and induction of host inflammatory response.

The second is chronic or latent infection, the exact mechanism of which is unknown, which frequently involves asymptomatic infection of lymphoid tissue.

Lastly, oncogenic transformation has been observed in rats. During oncogenesis, the replication cycle is truncated, and adenoviral DNA is then integrated into the host cell’s DNA. Thereafter, adenovirus produces potent E1A proteins that immortalize primary rodent cells by altering cellular transcription, ultimately leading to deregulation of apoptosis and malignant transformation.

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