title: Acute hepatitis with periportal confluent necrosis associated with human herpesvirus 6 infection in liver transplant patients.
abstract: OBJECTIVE
  To correlate human herpesvirus 6 (HHV-6) viral load with pathologic features in graft acute hepatitis of unknown origin.
  
  
  METHODS
  Liver frozen samples from 26 patients with graft hepatitis of unknown origin were available for HHV-6 DNA quantification.
  
  
  RESULTS
  In 10 (38.5%) of 26 liver samples, HHV-6 DNA was detectable, with a median viral load of 3.84 log10 copies/10⁶ cells. Confluent periportal necrosis was observed in 4 of 10 patients and associated with high viral load. These 4 patients responded to antiviral therapy. Mild unspecific hepatitis was observed in 4 patients with low intragraft viral load and in 2 patients with high viral load in a context of deep immunosuppression. Patients with HHV-6-negative graft hepatitis disclosed lobular necrotico-inflammatory activity without periportal necrosis.
  
  
  CONCLUSIONS
  Our study provides data supporting the pathogenic role of HHV-6 for liver allografts. The presence of confluent periportal necrosis could be a clue for prompt diagnosis of HHV-6-induced graft hepatitis.
authors: AP-HP, Hôpital Paul Brousse, Centre Hépato-Biliaire, Villejuif, France.
authors: Sophie
authors: S
authors: Buyse
authors: Anne-Marie
authors: AM
authors: Roque-Afonso
authors: Parissa
authors: P
authors: Vaghefi
authors: Michèle
authors: M
authors: Gigou
authors: Elisabeth
authors: E
authors: Dussaix
authors: Jean-Charles
authors: JC
authors: Duclos-Vallée
authors: Didier
authors: D
authors: Samuel
authors: Catherine
authors: C
authors: Guettier
mesh_terms: D000293:Adolescent; D000328:Adult; D004279:DNA, Viral; D005260:Female; D006505:Hepatitis / Q000473:pathology* / Q000821:virology; D015654:Herpesvirus 6, Human / Q000302:isolation & purification*; D006801:Humans; D008099:Liver / Q000473:pathology* / Q000821:virology; D016031:Liver Transplantation / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D019349:Roseolovirus Infections / Q000473:pathology* / Q000821:virology; D019562:Viral Load
chemical_list: D004279:DNA, Viral
keywords: Graft dysfunction; Graft hepatitis; Human herpesvirus 6; Liver transplantation