title: Detection of simultaneous beta-herpesvirus infections in clinical syndromes due to defined cytomegalovirus infection.
abstract: Human herpesvirus (HHV)-6 and HHV-7 are increasingly being recognized as emerging pathogens among transplant recipients. Using quantitative polymerase chain reaction assays, we demonstrate the presence of HHV-6 and/or HHV-7 in 18 of 20 episodes of clinically presumed or microbiologically confirmed cytomegalovirus (CMV) infection. Seventeen (89%) of 19 microbiologically confirmed cytomegalovirus (CMV)-infected patients had concomitant HHV-6 variant B (47%) and/or HHV-7 (63%) infection. The degree of HHV-6 coinfection was significantly correlated with hyperbilirubinemia while HHV-7 coinfection demonstrated a non-significant trend toward cytopenias. In one of the 20 episodes described herein, the 'viral syndrome' was due solely to HHV-7 infection; clinical and virological response was observed during intravenous ganciclovir therapy in this patient. While this study emphasizes the significance of HHV-6 and/or HHV-7 coinfection during episodes of CMV infection, it significantly highlights the novel observation of the causal role of HHV-7 (in the absence of HHV-6 and CMV) in a clinical illness presumed to be caused CMV. Thus, HHV-7 (and HHV-6) should be considered as a pathogen (or copathogen) in the viral syndromes following organ transplantation.
authors.affiliation: Division of Infectious Diseases and Internal Medicine, Mayo Clinic and Foundation, Rochester, MN 55905, USA.
authors.forename: Raymund R
authors.initials: RR
authors.lastname: Razonable
authors.forename: Antonio
authors.initials: A
authors.lastname: Rivero
authors.forename: Robert A
authors.initials: RA
authors.lastname: Brown
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Hart
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Espy
authors.forename: Hester
authors.initials: H
authors.lastname: van Cruijsen
authors.forename: Jennie
authors.initials: J
authors.lastname: Wilson
authors.forename: Cynthia
authors.initials: C
authors.lastname: Groettum
authors.forename: Walter
authors.initials: W
authors.lastname: Kremers
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Smith
authors.forename: Carlos V
authors.initials: CV
authors.lastname: Paya
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000494:pharmacology; D003587:Cytomegalovirus / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000097:blood / Q000150:complications*; D004279:DNA, Viral / Q000032:analysis / Q000187:drug effects; D005260:Female; D015774:Ganciclovir / Q000494:pharmacology; D015654:Herpesvirus 6, Human / Q000302:isolation & purification*; D016199:Herpesvirus 7, Human / Q000302:isolation & purification*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation; D016133:Polymerase Chain Reaction; D019349:Roseolovirus Infections / Q000097:blood / Q000150:complications*
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D015774:Ganciclovir