title: Primary and reactivated HHV8 infection and disease after liver transplantation: a prospective study.
abstract: Human herpesvirus 8 (HHV8) is pathogenic in humans, especially in cases of immunosuppression. We evaluated the risk of HHV8 transmission from liver donors, and its clinical impact in southern Italy, where its seroprevalence in the general population is reported to be as high as 18.3%. We tested 179 liver transplant recipients and their donors for HHV8 antibodies at the time of transplantation, and implemented in all recipients a 12-month posttransplant surveillance program for HHV8 infection. Of the 179 liver transplant recipients enrolled, 10.6% were HHV8 seropositive before transplantation, whereas the organ donor's seroprevalence was 4.4%. Eight seronegative patients received a liver from a seropositive donor, and four of them developed primary HHV8 infection. Two of these patients had lethal nonmalignant illness with systemic involvement and multiorgan failure. Among the 19 HHV8 seropositive recipients, two had viral reactivation after liver transplantation. In addition, an HHV8 seronegative recipient of a seronegative donor developed primary HHV8 infection and multicentric Castleman's disease. In conclusion, primary HHV8 infection transmitted from a seropositive donor to a seronegative liver transplant recipient can cause a severe nonmalignant illness associated with high mortality. Donor screening for HHV8 should be considered in geographic areas with a high prevalence of such infection.
authors.affiliation: Department of Gastroenterology and Hepatology, Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (ISMETT), University of Pittsburgh Medical Center, Palermo, Italy. gpietrosi@ismett.edu
authors.forename: G
authors.initials: G
authors.lastname: Pietrosi
authors.forename: G
authors.initials: G
authors.lastname: Vizzini
authors.forename: L
authors.initials: L
authors.lastname: Pipitone
authors.forename: G
authors.initials: G
authors.lastname: Di Martino
authors.forename: M I
authors.initials: MI
authors.lastname: Minervini
authors.forename: G
authors.initials: G
authors.lastname: Lo Iacono
authors.forename: P G
authors.initials: PG
authors.lastname: Conaldi
authors.forename: P
authors.initials: P
authors.lastname: Grossi
authors.forename: V
authors.initials: V
authors.lastname: Lamonaca
authors.forename: L
authors.initials: L
authors.lastname: Galatioto
authors.forename: S
authors.initials: S
authors.lastname: Gruttadauria
authors.forename: B
authors.initials: B
authors.lastname: Gridelli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000914:Antibodies, Viral / Q000097:blood; D005871:Castleman Disease / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D005260:Female; D006085:Graft Survival; D006566:Herpesviridae Infections / Q000453:epidemiology / Q000635:transmission* / Q000821:virology; D019288:Herpesvirus 8, Human / Q000472:pathogenicity*; D006801:Humans; D007124:Immunoenzyme Techniques; D007165:Immunosuppression Therapy; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D016036:Seroepidemiologic Studies; D015996:Survival Rate; D019562:Viral Load; D014766:Viremia / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral