Molecular subtypes of Adenovirus-associated acute respiratory infection outbreak in children in Northern Vietnam and risk factors of more severe cases

Dinh-Dung Nguyen, Lan Tuyet Phung, Huyen Thi Thanh Tran, Ha Thi Thanh Ly, Anh Hang Mai Vo, Nhung Phuong Dinh, Phuong Mai Doan, Anh Thi Nguyen, Luc Danh Dang, Thia Thi Doan, Khuong Thi Pham, Huong Lan Pham, Dai Xuan Hoang, Thao Ngoc Pham, Bao Thai Tran, Trang Thi Thuc Tran, Huong Thi Minh Le, An Nhat Pham, Antony Antoniou, Nhan Thi Ho*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Under the pressure of Human Adenovirus (HAdV)–associated acute respiratory infection (ARI) outbreak in children in Northern Vietnam in the end of 2022, this study was initiated to identify the HAdV subtype(s) and examine the associated clinical features and risk factors of more severe cases.

This study evaluated pediatric patients with ARI which had tested positive for HAdV between October and November 2022 using a multiplex real-time PCR panel. Nasopharyngeal aspirates or nasal swab samples were used for sequencing to identify HAdV subtypes. Clinical data were collected retrospectively.

Among 97 successfully sequenced samples, the predominant subtypes were HAdV-B3 (83%), HAdV-B7 (16%) and HAdV-C2 (1%). Lower respiratory manifestations were found in 25% of the patients of which 5% were diagnosed with severe pneumonia. There was no significant association between HAdV subtype and clinical features except higher white blood cell and neutrophil counts in those detected with HAdV-B3 (p<0.001). Co-detection of HAdV with ≥1 other respiratory viruses was found in 13/24(54%) of those with lower respiratory manifestations and 4/5(80%) of those with severe pneumonia (odds ratio (95% confidence interval) vs. those without = 10.74 (2.83, 48.17) and 19.44 (2.12, 492.73) respectively after adjusting for age, sex, birth delivery method, day of disease).

HAdV-B3 and HAdV-B7 were predominant in the outbreak. Co-detection of HAdV together with other respiratory viruses was a strong risk factor for lower respiratory tract illnesses and severe pneumonia. The findings advocate the advantages of multi-factor microbial panels for the diagnosis and prognosis of ARI in children.
Original languageEnglish
Article numbere0011311
Number of pages18
JournalPLoS Neglected Tropical Diseases
Issue number11
Publication statusPublished - 7 Nov 2023

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