title: Human herpesvirus-6 infections in kidney, liver, lung, and heart transplantation: review.
abstract: Human herpesvirus-6 (HHV-6), which comprises of HHV-6A and HHV-6B, is a common infection after solid organ transplantation. The rate of HHV-6 reactivation is high, although clinical disease is not common. Only 1% of transplant recipients will develop clinical illness associated with HHV-6 infection, and most are ascribable to HHV-6B. Fever, myelosuppression, and end-organ disease, including hepatitis and encephalitis, have been reported. HHV-6 has also been associated with various indirect effects, including a higher rate of CMV disease, acute and chronic graft rejection, and opportunistic infection such as invasive fungal disease. All-cause mortality is increased in solid organ transplant recipients with HHV-6 infection. HHV-6 is somewhat unique among human viruses because of its ability to integrate into the host chromosome. The clinical significance of chromosomally integrated HHV-6 is not yet defined, although a higher rate of bacterial infection and allograft rejection has been suggested. The diagnosis of HHV-6 is now commonly made using nucleic acid testing for HHV-6 DNA in clinical samples, but this can be difficult to interpret owing to the common nature of asymptomatic viral reactivation. Treatment of HHV-6 is indicated in established end-organ disease such as encephalitis. Foscarnet, ganciclovir, and cidofovir have been used for treatment.
authors.affiliation: Department of Virology, Helsinki University Hospital, and Helsinki University, Helsinki, Finland. irmeli.lautenschlager@hus.fi
authors.forename: Irmeli
authors.initials: I
authors.lastname: Lautenschlager
authors.forename: Raymund R
authors.initials: RR
authors.lastname: Razonable
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D016027:Heart Transplantation / Q000009:adverse effects; D015654:Herpesvirus 6, Human / Q000145:classification / Q000472:pathogenicity; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects; D016031:Liver Transplantation / Q000009:adverse effects; D016040:Lung Transplantation / Q000009:adverse effects; D016377:Organ Transplantation / Q000009:adverse effects*; D019349:Roseolovirus Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*
chemical_list: D000998:Antiviral Agents