Evaluation of Lytic and Persistent Human Adenovirus Infections in Tonsil Tissue of Children With Tonsillar Hypertrophy: A Matched Case–Control Study Publisher



Heydarifard Z^{1, 2} ; Zadheidar S¹ ; Kalantari S¹ ; Nejati A¹ ; Achak F³ ; Salimi V¹ ; Mokhtariazad T¹ ; Shafieijandaghi NZ¹ Show Affiliations
Source: Laryngoscope Investigative Otolaryngology Published:2025

Abstract

Background: Tonsillar hypertrophy is a common condition in children, and human adenoviruses (HAdVs) may contribute to its development. However, the mechanisms underlying HAdVs' persistence in tonsils remain unclear. This study investigates the role of HAdVs in tonsillar hypertrophy. Methods: In a case–control study, oropharyngeal swabs and tonsillar tissues were collected from 50 children with and without tonsillar hypertrophy. HAdV viral load, mRNA expression, and virus shedding were considered to differentiate lytic and persistent infections. Results: HAdV genomes were detected in 32% of hypertrophic tissues, exclusively HAdV-C, with no presence in controls. Viral loads varied, peaking in children under 5 years old, ranging from 4 × (Formula presented.) to 1.9 × (Formula presented.) copies/g, with a median of 2.6 × (Formula presented.) copies/g. Predominantly, infections were persistent (81%), with a smaller number of lytic or reactive cases. Conclusion: The study supports and extends previous findings regarding HAdV-C persistence in tonsillar tissues and its potential contribution to hypertrophy, with viral loads tending to decrease with age. These findings contribute to the growing body of evidence on HAdVs' role in tonsillar hypertrophy, reinforcing the importance of persistent infections in the tonsils. © 2025 The Author(s). Laryngoscope Investigative Otolaryngology published by Wiley Periodicals LLC on behalf of The Triological Society.