title: Human herpesvirus-6 infection after lung and heart-lung transplantation: a prospective longitudinal study.
abstract: BACKGROUND
  Although human herpesvirus (HHV)-6 is now recognized as a frequent pathogen after transplantation, the real impact of this infection in patients undergoing transplantation remains unclear.
  
  
  METHODS
  During 27 months, 30 consecutive heart-lung- and lung-transplant recipients were included on the day of transplantation and prospectively followed during 100 days for HHV-6 infection.
  
  
  RESULTS
  HHV-6 infection occurred in 20 (66%) patients after a median delay of 18 days after transplantation. The virus was detected by polymerase chain reaction or culture, or both, in 15.7 % of blood specimens, in 14.5% of bronchoalveolar lavage fluids, and in many organs at postmortem examination; it was found by culture in eight patients. No clinical manifestations could clearly be associated with HHV-6 alone. However, patients with HHV-6 infection had a higher mortality rate than patients without HHV-6 infection (7 of 20 vs. 0 of 10; P=0.04), and all the deceased patients died during periods of HHV-6 infection. We did not observe higher incidence of infectious or graft-rejection episodes in HHV-6-positive patients. However, eight of nine viral or fungal infections occurred during HHV-6 infection and three were directly responsible for death.
  
  
  CONCLUSIONS
  Although frequently detected after transplantation, HHV-6 was not associated with any specific clinical manifestation. The higher mortality rate observed in patients with HHV-6 infection was not related to a higher incidence of bacterial infections or graft rejection but might be associated with more viral and fungal infections.
authors.affiliation: Infectious Diseases Clinic, Erasme University Hospital, Brussels, Belgium. fjacobs@ulb.ac.be
authors.forename: Frédérique
authors.initials: F
authors.lastname: Jacobs
authors.forename: Christiane
authors.initials: C
authors.lastname: Knoop
authors.forename: Françoise
authors.initials: F
authors.lastname: Brancart
authors.forename: Philippe
authors.initials: P
authors.lastname: Gilot
authors.forename: Christian
authors.initials: C
authors.lastname: Mélot
authors.forename: Baudouin
authors.initials: B
authors.lastname: Byl
authors.forename: Marie-Luce
authors.initials: ML
authors.lastname: Delforge
authors.forename: Marc
authors.initials: M
authors.lastname: Estenne
authors.forename: Corinne
authors.initials: C
authors.lastname: Liesnard
mesh_terms: D000328:Adult; D002423:Cause of Death; D004279:DNA, Viral / Q000097:blood; D004359:Drug Therapy, Combination; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects* / Q000401:mortality; D016041:Heart-Lung Transplantation / Q000009:adverse effects* / Q000401:mortality; D015654:Herpesvirus 6, Human / Q000302:isolation & purification; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D016133:Polymerase Chain Reaction; D011183:Postoperative Complications / Q000401:mortality / Q000821:virology*; D011446:Prospective Studies; D019349:Roseolovirus Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D015996:Survival Rate; D013997:Time Factors
chemical_list: D004279:DNA, Viral; D007166:Immunosuppressive Agents