title: Impact of human herpesvirus-6 on the frequency and severity of recurrent hepatitis C virus hepatitis in liver transplant recipients.
abstract: A role of tumor necrosis factor-alpha (TNF-alpha) In the immunopathogenesis of hepatitis C virus (HCV) infection has been proposed. The novel herpes virus, human herpes virus-6 (HHV-6), is amongst the most potent inducers of cytokines, including TNF-alpha. The impact of HHV-6 viremia on the progression of recurrent HCV hepatitis was assessed in 51 HCV-positive liver transplant recipients. The frequency of recurrent HCV hepatitis did not differ between patients with HCV viremia (47.6%, 10/21) as compared with those without HCV viremia (46.7%, 14/30, p = 0.9). However, the patients with HHV-6 viremia had a significantly higher fibrosis score upon HCV recurrence than those without HHV-6 viremia (mean 1.5 vs. 0.3, p = 0.01). An association between cytomegalovirus (CMV) viremia and HCV recurrence was not documented; 50% (15/30) of the patients with CMV viremia and 42.8% (9/21) of those without CMV viremia had recurrent HCV hepatitis (p > 0.5). Receipt of ganciclovir (administered upon the detection of CMV viremia) was associated with lower total Knodell score (mean 5.2 vs. 6.9, p = 0.05) and a trend towards lower fibrosis score (mean 0.44 vs. 1.00, p = 0.12) in patients with recurrent HCV hepatitis. Thus, HHV-6 viremia in HCV-positive liver transplant recipients identified a subgroup of patients at increased risk for early fibrosis upon HCV recurrence.
authors.affiliation: Veteran Affairs Medical Center, Pittsburgh, PA, USA. nis5+@pitt.edu
authors.forename: Nina
authors.initials: N
authors.lastname: Singh
authors.forename: Shahid
authors.initials: S
authors.lastname: Husain
authors.forename: Donald R
authors.initials: DR
authors.lastname: Carrigan
authors.forename: Konstance K
authors.initials: KK
authors.lastname: Knox
authors.forename: Karen E
authors.initials: KE
authors.lastname: Weck
authors.forename: Marilyn M
authors.initials: MM
authors.lastname: Wagener
authors.forename: Timothy
authors.initials: T
authors.lastname: Gayowski
mesh_terms: D003587:Cytomegalovirus / Q000302:isolation & purification; D006526:Hepatitis C / Q000601:surgery* / Q000821:virology*; D018937:Hepatitis C Antibodies / Q000032:analysis; D015654:Herpesvirus 6, Human / Q000302:isolation & purification; D006801:Humans; D016031:Liver Transplantation; D008875:Middle Aged; D012008:Recurrence; D014766:Viremia / Q000150:complications*
chemical_list: D018937:Hepatitis C Antibodies