Human herpesviruses 6, 7 and 8 in solid organ transplant recipients.
Human herpesviruses (HHV) 6 and 7 are ubiquitous infections that reactivate commonly in transplant recipients. However, clinical diseases due to these viruses are reported only in 1% of solid organ transplant recipients. Fever, rash and bone marrow suppression are the most common manifestations, but symptoms of tissue invasive disease may be observed. Treatment of HHV-6 and HHV-7 disease includes antiviral therapy and cautious reduction in immunosuppression. HHV-8 is an oncogenic gamma-herpesvirus that causes Kaposi's sarcoma, Castleman's disease and primary effusion lymphomas in transplant recipients. Nonmalignant diseases such as bone marrow suppression and multiorgan failure have also been associated with HHV-8. Reduction in immunosuppression is the first line treatment of HHV-8 infection. Other alternatives for treatment, especially for HHV-8 diseases not responsive to immuno-minimization strategies, are surgery and chemotherapy. Sirolimus has been shown to be a beneficial component for the treatment of Kaposi's sarcoma and the role of antivirals for HHV-8 infection is being investigated.
Division of Infectious Diseases, Department of Medicine, College of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. razonable.raymund@mayo.edu
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D000998:Antiviral Agents / Q000627:therapeutic use; D006566:Herpesviridae Infections / Q000150:complications* / Q000209:etiology; D015654:Herpesvirus 6, Human / Q000378:metabolism*; D016199:Herpesvirus 7, Human / Q000378:metabolism*; D019288:Herpesvirus 8, Human / Q000378:metabolism*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D016377:Organ Transplantation / Q000009:adverse effects*; D012514:Sarcoma, Kaposi / Q000150:complications / Q000188:drug therapy; D020123:Sirolimus / Q000627:therapeutic use
D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D020123:Sirolimus