title: Clinical significance of pretransplant chromosomally integrated human herpesvirus-6 in liver transplant recipients.
abstract: BACKGROUND
  The clinical relevance of chromosomally integrated human herpesvirus-6 (CIHHV-6) after transplantation is not known. This study was aimed to determine the potential role of CIHHV-6 on the occurrence of other infections, allograft rejection, and outcomes after liver transplantation.
  
  
  METHODS
  A real-time quantitative human herpesvirus-6 (HHV-6) polymerase chain reaction assay was performed on whole blood samples of 548 liver transplant recipients. Clinical characteristics and outcomes of the patients with CIHHV-6 (defined as HHV-6 levels >1 × 10(6) genomes/mL) were compared with those of patients with low-level or no HHV-6 DNAemia.
  
  
  RESULTS
  Seven had CIHHV-6, 35 had low-level HHV-6 DNAemia, and 506 had no HHV-6 DNAemia before liver transplantation. Bacterial infection was significantly more common in the CIHHV-6 group compared with the group without HHV-6 (71.4% vs. 31.4%; P = 0.04). A higher rate of allograft rejection was observed in the CIHHV-6 group compared with the group with low-level HHV-6 DNAemia (71.4% vs. 37.1%; P = 0.12) and those without HHV-6 DNAemia (71.4% vs. 42.9%; P = 0.25), although these differences did not reach statistical significance. Other opportunistic infections and outcomes were not significantly different between the CIHHV-6 group and the non-CIHHV-6 groups.
  
  
  CONCLUSIONS
  Patients with CIHHV-6 may be at increased risk of indirect HHV6 effects after transplantation. This clinically relevant observation warrants confirmation using a larger cohort of transplant recipients.
authors.affiliation: Division of Infectious Diseases, College of Medicine, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Sang-Oh
authors.initials: SO
authors.lastname: Lee
authors.forename: Robert A
authors.initials: RA
authors.lastname: Brown
authors.forename: Raymund R
authors.initials: RR
authors.lastname: Razonable
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002875:Chromosomes / Q000235:genetics / Q000821:virology*; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology*; D015654:Herpesvirus 6, Human / Q000235:genetics*; D006801:Humans; D008099:Liver / Q000821:virology; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000453:epidemiology*; D011379:Prognosis; D012307:Risk Factors; D019349:Roseolovirus Infections / Q000150:complications*; D014180:Transplantation; D055815:Young Adult
chemical_list: D004279:DNA, Viral