Impact of human herpesvirus-6 on the frequency and severity of recurrent hepatitis C virus hepatitis in liver transplant recipients.
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.
Singh
Nina
N
Veteran Affairs Medical Center, Pittsburgh, PA, USA. nis5+@pitt.edu
Husain
Shahid
S
Carrigan
Donald R
DR
Knox
Konstance K
KK
Weck
Karen E
KE
Wagener
Marilyn M
MM
Gayowski
Timothy
T
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*
D018937:Hepatitis C Antibodies