title: Human herpesvirus-6 is associated with cytomegalovirus reactivation in liver transplant recipients.
abstract: Human herpesvirus-6 (HHV-6) may be a risk factor for cytomegalovirus (CMV) disease in posttransplant patients, possibly through a direct interaction or through a general immunomodulatory effect. To examine this possibility, 88 liver transplant recipients were monitored with serial HHV-6 polymerase chain reaction (PCR), CMV antigenemia, and CMV plasma viral load. HHV-6 infection was defined by a positive PCR of peripheral blood lymphocytes. Forty-eight (54.4%) of 88 patients had at least 1 positive HHV-6 PCR. CMV recurrence was significantly more common in patients with HHV-6 infection (38/48 patients [79. 2%]), compared with recurrence in those without HHV-6 infection (18/40 patients [45%]; P=.001). Peak CMV viral load was 24, 147+/-6799 copies/mL in patients with HHV-6 infection versus 8391+/-4598 copies/mL in patients without HHV-6 infection (P=.001). Symptomatic CMV disease was more common in patients with HHV-6 infection than it was in those without infection (15/48 patients [31. 3%] vs. 4/10 patients [10.0%]; P=.013). In a multivariate analysis including other risk factors for CMV, HHV-6 infection remained an independent risk factor for CMV disease (P=.013; odds ratio, 7.26; 95% confidence interval, 1.52-34.72). HHV-6 is associated with CMV infection and disease, thus supporting an interaction between these viruses.
authors.affiliation: Department of Medicine, Division of Infectious Diseases and Multi-Organ Transplantation, Toronto General Hospital-University Health Network, Toronto, Ontario M5G 2C4, Canada. Atul.Humar@uhn.on.ca
authors.forename: A
authors.initials: A
authors.lastname: Humar
authors.forename: G
authors.initials: G
authors.lastname: Malkan
authors.forename: G
authors.initials: G
authors.lastname: Moussa
authors.forename: P
authors.initials: P
authors.lastname: Greig
authors.forename: G
authors.initials: G
authors.lastname: Levy
authors.forename: T
authors.initials: T
authors.lastname: Mazzulli
mesh_terms: D000293:Adolescent; D000368:Aged; D003586:Cytomegalovirus Infections / Q000097:blood / Q000209:etiology*; D005260:Female; D006566:Herpesviridae Infections / Q000150:complications* / Q000821:virology; D015654:Herpesvirus 6, Human; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016133:Polymerase Chain Reaction; D012307:Risk Factors; D019562:Viral Load