Fever, human herpesvirus-6 (HHV-6) seroconversion, and acute rejection episodes as a function of the initial seroprevalence for HHV-6 in renal transplant recipients.
Human herpesvirus-6 (HHV-6) is an opportunistic viral pathogen of emerging clinical significance in immunocompromised patients. We performed a seroepidemiological survey to test the relation between seroprevalence among donors and recipients for HHV-6 at three endpoints. Before transplantation sera obtained from cadaveric donors and from potential recipients were tested for IgG antibodies against HHV-6 using an enzyme-linked immunoassay. The group of recipient sera, including samples obtained before as well as 2, 4, 12, and 48 weeks after transplantation, were tested for anti-HHV-6 IgM antibodies using an indirect immunofluorescence assay. The statistical analysis was performed with the Cox proportional hazards models. The HHV-6 seronegative group (n = 11) compared with the HHV-6 seropositive group (n = 109) showed twice the risk of HHV-6 IgM seroconversion (RR = 2.24; P < .04), with a greater risk of fever, namely 3.8, which was on the verge of statistical significance. The opposite trend toward an association with acute rejection episodes was observed among HHV-6 seronegative patients (RR = 1.81). The presence of IgG antibody in the sera of donors to IgG seropositive recipients had no association with the occurrence of IgM seroconversion. In contrast, IgM antibodies to HHV-6 appeared in four of five seronegative patients who received allografts from IgG seropositive donors. These preliminary data suggest that the effects seem to be the consequence of HHV-6 transmission through a renal allograft.
Deborska-Materkowska
D
D
Transplantation Institute, Department of Transplant Medicine and Nephrology, Warsaw Medical University, ul. Nowogrodzka 59, 02-006 Warsaw, Poland. dominika.deborska@wp.pl
Lewandowski
Z
Z
Sadowska
A
A
Nowacka-Cieciura
E
E
Chudziński
W
W
Czerwiński
J
J
Paczek
L
L
Durlik
M
M
D000914:Antibodies, Viral / Q000097:blood; D005334:Fever / Q000821:virology*; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology* / Q000821:virology; D015654:Herpesvirus 6, Human / Q000302:isolation & purification; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D016030:Kidney Transplantation / Q000473:pathology*; D011183:Postoperative Complications / Q000821:virology*; D016016:Proportional Hazards Models; D019349:Roseolovirus Infections / Q000453:epidemiology*; D016036:Seroepidemiologic Studies; D013997:Time Factors
D000914:Antibodies, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M