title: Human herpesvirus 6 reactivation is associated with cytomegalovirus infection and syndromes in kidney transplant recipients at risk for primary cytomegalovirus infection.
abstract: A potential association between human herpesvirus 6 (HHV-6) and cytomegalovirus (CMV) following kidney transplantation was explored by retrospectively testing serial serum specimens for HHV-6 IgG and IgM antibody. HHV-6 reactivation occurred in 35 (66%) of 53 transplant recipients. Fungal or parasitic opportunistic infections, graft rejection or loss, and mortality were not associated with HHV-6 reactivation. HHV-6 reactivation was associated with primary CMV infection (P=.001) and CMV syndrome (P=.003) and with trends for CMV-related hepatitis (P=.095), CMV-related neutropenia (P=.104), and serious CMV disease (P=.085). After controlling for CMV immune globulin (CMVIG) prophylaxis, the association between HHV-6 reactivation and primary CMV infection and syndrome remained significant (P=.002 and 0.006, respectively). The reduction in CMV syndrome among those receiving CMVIG prophylaxis remained significant (P=.007) after controlling for HHV-6 reactivation. HHV-6 reactivation in kidney transplant recipients at risk for primary CMV infection is associated with CMV infection and CMV-related disease, and these effects are independent of CMVIG prophylaxis.
authors.affiliation: Departments of Medicine and Pathology, New England Medical Center and Tuffs University School of Medicine, Boston, MA 02111, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: DesJardin
authors.forename: L
authors.initials: L
authors.lastname: Gibbons
authors.forename: E
authors.initials: E
authors.lastname: Cho
authors.forename: S E
authors.initials: SE
authors.lastname: Supran
authors.forename: M E
authors.initials: ME
authors.lastname: Falagas
authors.forename: B G
authors.initials: BG
authors.lastname: Werner
authors.forename: D R
authors.initials: DR
authors.lastname: Snydman
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003587:Cytomegalovirus / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000276:immunology / Q000517:prevention & control*; D005260:Female; D006505:Hepatitis / Q000453:epidemiology; D006566:Herpesviridae Infections / Q000150:complications* / Q000276:immunology / Q000503:physiopathology*; D015654:Herpesvirus 6, Human / Q000254:growth & development* / Q000302:isolation & purification; D006801:Humans; D007116:Immunization, Passive; D007136:Immunoglobulins; D016756:Immunoglobulins, Intravenous; D016030:Kidney Transplantation; D008297:Male; D009503:Neutropenia / Q000517:prevention & control; D011183:Postoperative Complications; D011446:Prospective Studies; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D014775:Virus Activation
chemical_list: D007136:Immunoglobulins; D016756:Immunoglobulins, Intravenous; C045781:cytomegalovirus-specific hyperimmune globulin