Human herpesviruses 6 and 7 as potential pathogens after liver transplant: prospective comparison with the effect of cytomegalovirus.
Because cytomegalovirus (CMV) is an important opportunistic infection after liver transplant, we conducted a prospective study to see if the same applied to human herpesviruses (HHV)-6 and -7. We used polymerase chain reaction (PCR) methods optimised to detect active, not latent, infection and studied patients not receiving antiviral prophylaxis for CMV. Post-transplant, 536 blood samples were tested by PCR (median 7; range 4-50). Active infection with CMV was detected in 28/60 (47%), HHV-6 in 19/60 (32%), and HHV-7 in 29/60 (48%) of patients. The PCR-positive samples were tested by quantitative-competitive PCR to measure the virus load of each betaherpesvirus. The median peak virus load for CMV was significantly greater than that for HHV-6 or HHV-7. Detailed clinicopathological analyses for the whole population showed that CMV and HHV-6 were each significantly associated with biopsy-proven graft rejection. Individual case histories suggested that HHV-6 and HHV-7 may be the cause of some episodes of hepatitis and pyrexia. It is concluded that HHV-6 is a previously unrecognized contributor to the morbidity of liver transplantation, that HHV-7 may also be important and that both viruses should be included in the differential diagnosis of graft dysfunction.
Griffiths
P D
PD
Department of Virology, Royal Free Hospital and Royal Free and University College Medical School, London, England.
Ait-Khaled
M
M
Bearcroft
C P
CP
Clark
D A
DA
Quaglia
A
A
Davies
S E
SE
Burroughs
A K
AK
Rolles
K
K
Kidd
I M
IM
Knight
S N
SN
Noibi
S M
SM
Cope
A V
AV
Phillips
A N
AN
Emery
V C
VC
D000328:Adult; D000410:Alanine Transaminase / Q000378:metabolism; D003587:Cytomegalovirus / Q000302:isolation & purification / Q000502:physiology*; D003586:Cytomegalovirus Infections / Q000209:etiology / Q000821:virology; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006566:Herpesviridae Infections / Q000209:etiology / Q000473:pathology / Q000821:virology*; D015654:Herpesvirus 6, Human / Q000502:physiology*; D016199:Herpesvirus 7, Human / Q000502:physiology*; D006801:Humans; D008099:Liver / Q000201:enzymology / Q000821:virology; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D016133:Polymerase Chain Reaction / Q000379:methods; D011446:Prospective Studies; D019562:Viral Load
D004279:DNA, Viral; D000410:Alanine Transaminase