title: Human herpesviruses 6 and 7 as potential pathogens after liver transplant: prospective comparison with the effect of cytomegalovirus.
abstract: 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.
authors.affiliation: Department of Virology, Royal Free Hospital and Royal Free and University College Medical School, London, England.
authors.forename: P D
authors.initials: PD
authors.lastname: Griffiths
authors.forename: M
authors.initials: M
authors.lastname: Ait-Khaled
authors.forename: C P
authors.initials: CP
authors.lastname: Bearcroft
authors.forename: D A
authors.initials: DA
authors.lastname: Clark
authors.forename: A
authors.initials: A
authors.lastname: Quaglia
authors.forename: S E
authors.initials: SE
authors.lastname: Davies
authors.forename: A K
authors.initials: AK
authors.lastname: Burroughs
authors.forename: K
authors.initials: K
authors.lastname: Rolles
authors.forename: I M
authors.initials: IM
authors.lastname: Kidd
authors.forename: S N
authors.initials: SN
authors.lastname: Knight
authors.forename: S M
authors.initials: SM
authors.lastname: Noibi
authors.forename: A V
authors.initials: AV
authors.lastname: Cope
authors.forename: A N
authors.initials: AN
authors.lastname: Phillips
authors.forename: V C
authors.initials: VC
authors.lastname: Emery
mesh_terms: 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
chemical_list: D004279:DNA, Viral; D000410:Alanine Transaminase