Human herpesvirus-6 and -7 after lung and heart-lung transplantation.
BACKGROUND
The impact of herpesvirus-6 and -7 (HHV-6, HHV-7) activation in lung transplant recipients is still poorly understood. We report the appearance of HHV-6 and HHV-7 antigenemia after lung transplantation and evaluate the efficacy of anti-viral drugs against these viruses.


METHODS
Twenty-two lung or heart-lung recipients were monitored for HHV-6, HHV-7 and cytomegalovirus (CMV) during 12 post-operative months. HHV-6- and HHV-7-specific antigens and CMV pp65 antigens were analyzed in blood leukocytes and bronchoalveolar lavage fluid cells by monoclonal antibodies. Ganciclovir or valganciclovir prophylaxis for a minimum of 3 months was given to 19 recipients at risk for CMV infection.


RESULTS
HHV-6, HHV-7 and CMV antigenemia was detected in 20 (91%), 11 (50%) and 12 (55%) recipients (median 16, 31 and 165 days) after transplantation, respectively. HHV-6 antigenemia occurred in 15 (79%), HHV-7 antigenemia in 7 (37%) and CMV antigenemia in 1 (7%) of these patients during anti-viral prophylaxis. HHV-6 or HHV-7 antigenemia was frequently associated with CMV antigenemia, which was detected 3 to 12 months after transplantation. Ganciclovir or valganciclovir treatment of CMV infection was effective against the concomitant HHV-6 and HHV-7 antigenemia in 9 of 12 (75%) and 5 of 6 (83%) cases, respectively. One case of pneumonitis and 1 of encephalitis were temporally associated with HHV-6. No other clinical manifestations could be linked solely to HHV-6 or -7.


CONCLUSIONS
HHV-6 and -7 antigenemia was common and appeared early after lung transplantation. CMV prophylaxis was not able to prevent the appearance of HHV-6 and -7 antigenemia.
Lehto
Juho T
JT
Department of Medicine, Division of Respiratory Diseases, Helsinki University Central Hospital, Helsinki, Finland. juho.lehto@fimnet.fi
Halme
Maija
M
Tukiainen
Pentti
P
Harjula
Ari
A
Sipponen
Jorma
J
Lautenschlager
Irmeli
I
D000328:Adult; D000368:Aged; D000956:Antigens, Viral / Q000276:immunology*; D000998:Antiviral Agents / Q000627:therapeutic use; D001992:Bronchoalveolar Lavage Fluid / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation; D015654:Herpesvirus 6, Human / Q000276:immunology*; D016199:Herpesvirus 7, Human / Q000276:immunology*; D006801:Humans; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D019349:Roseolovirus Infections / Q000453:epidemiology / Q000517:prevention & control / Q000821:virology*
D000956:Antigens, Viral; D000998:Antiviral Agents