The impact of human herpesvirus-6 and -7 infection on the outcome of liver transplantation.
Human herpesvirus (HHV)-6 and -7 are novel members of the beta-herpesvirus family that maintain latency in the human host after primary infection. Reactivation from latency and/or increased degree of viral replication occurs during periods of immune dysfunction. The clinical effect of HHV-6 and HHV-7 reactivation in recipients of liver transplants is now being recognized. Clinical illnesses such as fever, rash, pneumonitis, encephalitis, hepatitis, and myelosuppression have been described in a number of anecdotal reports. Moreover, a growing body of evidence suggests that the more important effect of HHV-6 and HHV-7 reactivation on the outcomes of liver transplantation may be mediated indirectly by their interactions with the other beta-herpesvirus-cytomegalovirus (CMV). Coinfection among these three beta-herpesviruses in clinical syndromes that were classically ascribed to be solely caused by CMV has been shown and has raised substantial interest in the potential role of HHV-6 and HHV-7 as copathogens in the direct and indirect illnesses caused by CMV. This article reviews the current scientific data on the role and the magnitude of impact of HHV-6 and HHV-7 infection on the outcomes of liver transplantation.
Razonable
Raymund R
RR
Division of Infectious Diseases and Internal Medicine, Mayo Clinic and Foundation, Rochester, MN 55905, USA.
Paya
Carlos V
CV
D015654:Herpesvirus 6, Human; D016199:Herpesvirus 7, Human; D006801:Humans; D016031:Liver Transplantation; D011183:Postoperative Complications / Q000821:virology*; D019349:Roseolovirus Infections / Q000175:diagnosis / Q000503:physiopathology* / Q000517:prevention & control; D016896:Treatment Outcome