title: Herpes simplex virus load to monitor antiviral treatment after liver transplantation for acute herpetic hepatitis.
abstract: Herpes simplex virus (HSV) hepatitis is an uncommon cause of acute liver failure (ALF), primarily affecting immunocompromised patients. So far, 148 cases have been published, of which 9 underwent liver transplantation (LT). The reported post-transplant survival is poor, with over 60% dying in the first year. Dosing and duration of antiviral therapy after LT are not established. Concerns include both the risk of hepatic recurrence after LT and emergence of viral resistance during prolonged therapy. HSV DNA plasma levels might be helpful to monitor therapeutic response and guide duration of therapy. We present a case of ALF complicating a primary HSV-1 infection in an immunocompetent host, who required emergency LT. We further discuss the value of measuring serial HSV DNA plasma loads to monitor antiviral therapy.
authors.affiliation: Service of Infectious Diseases, Department of Medical Specialities, University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: Juan
authors.initials: J
authors.lastname: Ambrosioni
authors.forename: Laurent
authors.initials: L
authors.lastname: Kaiser
authors.forename: Emiliano
authors.initials: E
authors.lastname: Giostra
authors.forename: Pascal
authors.initials: P
authors.lastname: Meylan
authors.forename: Gilles
authors.initials: G
authors.lastname: Mentha
authors.forename: Christian
authors.initials: C
authors.lastname: Toso
authors.forename: Muriel
authors.initials: M
authors.lastname: Genevay-Infante
authors.forename: Laura
authors.initials: L
authors.lastname: Rubbia-Brandt
authors.forename: Christian
authors.initials: C
authors.lastname: van Delden
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use; D004279:DNA, Viral / Q000097:blood; D006505:Hepatitis / Q000401:mortality / Q000821:virology*; D006561:Herpes Simplex / Q000188:drug therapy; D006566:Herpesviridae Infections / Q000188:drug therapy; D018259:Herpesvirus 1, Human / Q000187:drug effects; D006801:Humans; D017114:Liver Failure, Acute / Q000821:virology*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D018139:Simplexvirus / Q000187:drug effects*; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D000212:Acyclovir