title: Simultaneous monitoring of CMV and human herpesvirus 6 infections and diseases in liver transplant patients: one-year follow-up.
abstract: OBJECTIVE
  The aim of this study was to simultaneously monitoring cytomegalovirus and human herpesvirus 6 active infections using nested-polymerase chain reaction and, together with clinical findings, follow the clinical status of patients undergoing liver transplant.
  
  
  BACKGROUND
  The human β-herpesviruses, including cytomegalovirus and human herpesvirus 6, are ubiquitous among human populations. Active infections of human herpesvirus 6 and cytomegalovirus are common after liver transplantation, possibly induced and facilitated by allograft rejection and immunosuppressive therapy. Both viruses affect the success of the transplant procedure.
  
  
  METHODS
  Thirty patients submitted to liver transplant at the Liver Transplant Unit, at the Gastro Center, State University of Campinas, SP, Brazil, were studied prospectively from six months to one year, nested-polymerase chain reaction for cytomegalovirus and human herpesvirus 6 DNA detections. Two or more consecutive positive nested-polymerase chain reaction were considered indicative of active infection.
  
  
  RESULTS
  Active infection by cytomegalovirus was detected in 13/30 (43.3%) patients, median time to first cytomegalovirus detection was 29 days after transplantation (range: 0-99 days). Active infection by human herpesvirus 6 was detected in 12/30 (40%) patients, median time to first human herpesvirus 6 detection was 23.5 days after transplantation (range: 0-273 days). The time-related appearance of each virus was not statistically different (p = 0.49). Rejection of the transplanted liver was observed in 16.7% (5/30) of the patients. The present analysis showed that human herpesvirus 6 and/or cytomegalovirus active infections were frequent in liver transplant recipients at our center.
  
  
  CONCLUSIONS
  Few patients remain free of betaherpesviruses after liver transplantation. Most patients presenting active infection with more than one virus were infected sequentially and not concurrently. Nested-polymerase chain reaction can be considered of limited value for clinically monitoring cytomegalovirus and human herpesvirus 6.
authors.affiliation: Faculty of Medical Sciences, State University of Campinas, Campinas, SP, Brazil. costa@fcm.unicamp.br
authors.forename: Fernanda Aparecida
authors.initials: FA
authors.lastname: Costa
authors.forename: Marcelo Naoki
authors.initials: MN
authors.lastname: Soki
authors.forename: Paula Durante
authors.initials: PD
authors.lastname: Andrade
authors.forename: Sandra Helena Alves
authors.initials: SH
authors.lastname: Bonon
authors.forename: Ronaldo Luis
authors.initials: RL
authors.lastname: Thomasini
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Sampaio
authors.forename: Marcelo de Carvalho
authors.initials: Mde C
authors.lastname: Ramos
authors.forename: Claudio Lúcio
authors.initials: CL
authors.lastname: Rossi
authors.forename: Teresa Cristina
authors.initials: TC
authors.lastname: Cavalcanti
authors.forename: Ilka de Fatima
authors.initials: Ide F
authors.lastname: Boin
authors.forename: Marília
authors.initials: M
authors.lastname: Leonard
authors.forename: Luiz Sérgio
authors.initials: LS
authors.lastname: Leonard
authors.forename: Raquel Bello
authors.initials: RB
authors.lastname: Stucchi
authors.forename: Sandra Cecília Botelho
authors.initials: SC
authors.lastname: Costa
mesh_terms: D003587:Cytomegalovirus / Q000235:genetics / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000175:diagnosis*; D004279:DNA, Viral / Q000032:analysis / Q000235:genetics; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000821:virology; D015654:Herpesvirus 6, Human / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects* / Q000276:immunology; D016133:Polymerase Chain Reaction; D011183:Postoperative Complications / Q000175:diagnosis / Q000821:virology; D011446:Prospective Studies; D019349:Roseolovirus Infections / Q000175:diagnosis*; D018709:Statistics, Nonparametric; D013997:Time Factors
chemical_list: D004279:DNA, Viral