title: Association of human herpesvirus 6 reactivation with severe cytomegalovirus-associated disease in orthotopic liver transplant recipients.
abstract: To explore the possible interaction between human herpesvirus 6 (HHV-6) and cytomegalovirus (CMV) in patients who have undergone organ transplantation, stored serum samples from 139 orthotopic liver transplant recipients were tested for HHV-6 immunoglobulin (Ig) G and IgM antibodies. HHV-6 reactivation occurred in 87 patients (62.6%) and was associated with CMV disease (P=.01), severe CMV-associated disease (P=.01), older age (P=.005), and use of muromonab-CD3 (Orthoclone; Orthobiotech) as treatment for rejection (P=.02). Trends for an association between HHV-6 reactivation and invasive fungal disease (P=.12), bacteremia (P=.10), and graft loss (P=.12) were seen. In a multivariate analysis of risk factors for severe CMV-associated disease, HHV-6 reactivation (relative risk [RR], 3.5; 95% confidence interval [CI], 1.2-10.2; P=.02), CMV donor-positive-recipient-negative match (RR, 5.7; 95% CI, 2.5-13.2; P<.001), and elevated serum creatinine level (P<.0001) were independent predictors. HHV-6 reactivation is associated with severe CMV-associated disease in liver transplant recipients.
authors.affiliation: Department of Medicine, New England Medical Center, Boston, MA 02111, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: DesJardin
authors.forename: E
authors.initials: E
authors.lastname: Cho
authors.forename: S
authors.initials: S
authors.lastname: Supran
authors.forename: L
authors.initials: L
authors.lastname: Gibbons
authors.forename: B G
authors.initials: BG
authors.lastname: Werner
authors.forename: D R
authors.initials: DR
authors.lastname: Snydman
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D003587:Cytomegalovirus / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000175:diagnosis / Q000821:virology; D005260:Female; D006566:Herpesviridae Infections / Q000175:diagnosis* / Q000821:virology; D015654:Herpesvirus 6, Human / Q000254:growth & development* / Q000276:immunology; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014775:Virus Activation
chemical_list: D000914:Antibodies, Viral