Pathogenicity and virulence of human adenovirus F41: Possible links to severe hepatitis in children

Figures & data

Figure 1. Nucleotide sequence alignment of the GABP1 and E2F binding sites in the E1A enhancer regions from adenovirus species. The binding sites as designated in [46] are shown, together with the corresponding nucleotide sequences from HAdV-F40 and F41. Conserved nucleotides are in red.

Figure 2. Locations of ORFs in the E4 genes of HAdV-F40. Locations of transcripts are shown as blocks. E4 transcripts are labelled with the number of constituent amino acids as in the original publication. The HAdV-F41 gene is arranged identically to that of HAdV-F40. Based on data from [16].

Figure 3. Locations of ORFs in the E3 and fibre genes of HAdV-F41. Locations of transcripts are shown as blocks. E3 transcripts are labelled RL1–6. The constituent amino acid numbers are shown. Based on data from [52].

Table 1. AAV-2 and HAdV detected in cases of hepatitis of unknown origin. Summary of data from studies by [143; 145] and [144].

	Ho et al. 2023[143]	Servellita et al. 2023[145]	Morfopoulou et al. 2023[144]
Number of cases	32	16	38
Median age	4.1 years	3 years	<10 years
Number of controls	25 immunocompetent Including 12 HAdV positive controls	113	66 immunocompetent 21 immunocompromised
AAV-2 detected	9/9	13/14	27/28
HAdV detected	6/9	14/14 (10/14 HAdV-F41).	22/23
HHV-6B detected	3/9	7/14 (11/14 positive for EBV)	16/23
Viruses detected in the livers of patients	AAV-2 4/4	AAV-2 0/8 HAdV 3/8	AAV-2 5/5 HHV-6B 5/5
AAV-2 in controls	0/25	4/113	6/65 in blood of immunocompetent cases. 6/17 of immunocompromised cases.
HAdV in controls	0/13 in healthy controls 6/12 in HAdV-positive controls	9/113	1/65
HHV-6B in controls	0/13 in healthy controls 9/12 in HAdV positive controls.	1/113	0/2 livers
COVID-19 vaccination	0	Not known	Not known
SARS-Cov-2 infection	3/31 but 12/23 had evidence of past infection.	Not detected in cases or controls	15/20 seropositive
DRB1 × 04:01 allele	25/27 compared with 10/64 in controls	Not determined	12/13

Figure 4. Cartoon showing possible factors contributing to severe acute childhood hepatitis “of unknown origin.”

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Data Availability statement

All data mentioned and referenced in this review is available and open to use without restriction.