3.4 Comparison of the clinical characteristics of the AGE patients infected with HAdV-F and non HAdV-F (Subgroup A, B, C, D, untypeable penton) adenoviruses
Mean Vesikari score of the patients infected with different subgroups A (n=11, 11.82 ± 2.56), B (n=5, 10.20 ± 1.30) C (n=7, 11.71 ± 2.360) and D (n= 2, 12.0 ± 1.41) and F (n=32; 12.2± 2.35)) as well as comparison of HAdV-F versus non-HAdV-F strains (n=29; 11.48 ± 2.41) showed no significant difference (Table 5, p >0.05). There was no significant difference in the mean number of days, mean number of episodes per 24 hr. of diarrhea and vomiting as well as the body temperature of the patients among these groups (Table 5).
The AGE patients infected with only HAdV-F (n=28, cases with co-infection of RVA or NoV were omitted from the analysis) and only non-HAdV-F strains (n=21) showed 18 (64.2%) and 13 (61.9%) patients with high body temperature and 25 (89.3%) and 15 (71.4%) with a clinical history of vomiting respectively. These proportions were not significantly different from each other (p=0.864; p = 0.110 respectively). Similar comparison for <5% and >5% degree of dehydration (HAdV-F: 78.6% (22/28), non HAdV-F: 79.2% (16/21); p = 0.843), and severe and very severe disease outcome (HAdV-F: 82% (23/28), non HAdV-F: 57% (12/21); p = 0.055) showed no significant difference. The number of days and number of episodes in 24 hrs duration of diarrhea ranged between 1-5 days (Median 3) and 4-25 episodes (Median 10) for HAdV-F and 1-4 days (Median 3) and 4-20 episodes (Median 7) for non-HAdV-F patients. Analysis of the vomiting days and episodes indicated 0-4 days (median 2), and 0-20 episodes (median 4) in HAdV-F and 0-4 days (median 1) and 0-8 episodes (median 3) in non-HAdV-F patients.
Each group of patients, with only HAdV-A (n=8), HAdV-B (n=5), HAdV-C (n=5), HAdV-D(n=1), and penton untypeable (n=2) adenovirus infection was compared for clinical characteristics with HAdV-F (n=28) strains. No significant difference for the percentage of patients with high body temperature, 5% or more dehydration and severe disease outcome was observed with a single exception. In the case of subgroup B infections significantly low number of cases with severe disease outcome (40.0%) were observed as compared to subgroup F infections (82.1%) (p = 0.043).
Comparison of the clinical characteristics of the patients infected with HAdV-40 (n=13) and HAdV-41(n=16) with each other showed no significant difference. The vomiting episodes per 24 hr. ranged between 0-20 (Median 4) for HAdV-40 patients and 0-5 (Median 3) for HAdV-41 patients.
Mixed infection of HAdV (Subgroup F, n=3; Subgroup A, n=1; Subgroup D, n=1, non-typable , n=2) and RVA (G1P[8], n=5; G2P[4], n=1; G9P[4], n=1) was observed in a total of 7 AGE patients aged between 14 - 29 months of age. These seven cases were distributed in Ahmadabad (n=3), Surat (n=2), Pune (n=1), and Mumbai (n=1), and four of them with severe disease outcomes were infected with HAdV-31 (Subgroup A), HAdV-69 (Subgroup D) and non typable penton strains.