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Human herpesvirus 6 infection in adult living related liver transplant recipients
Author(s) -
Ohashi Masahiro,
Sugata Ken,
Ihira Masaru,
Asano Yoshizo,
Egawa Hiroto,
Takada Yasutsugu,
Uemoto Shinji,
Yoshikawa Tetsushi
Publication year - 2008
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.21304
Subject(s) - viremia , medicine , liver transplantation , immunology , viral load , cirrhosis , serology , transplantation , virology , human herpesvirus 6 , antibody , titer , virus , viral disease , herpesviridae
To analyze human herpesvirus 6 (HHV‐6) infection in adult living related liver transplantation, we performed a virological analysis, including viral isolation, serological assay, and real‐time polymerase chain reaction, of serially collected blood samples from 67 recipients. In addition, cytokine levels were measured to determine their role in viral reactivation. HHV‐6 was isolated from only 4 recipients (6.0%), and viral DNA was detected in 15 (22.4%) of the 67 recipients. A significant increase in HHV‐6 immunoglobulin G antibody titers was observed in 19 (28.4%) of the 67 recipients. Finally, 26 recipients (38.8%) had HHV‐6 reactivation 2‐6 weeks after transplantation. HHV‐6 associated clinical features were analyzed in the 17 recipients presenting with either viremia or DNAemia. Two recipients with viremia and 3 recipients with DNAemia had unexplained fever at the time of viral infection. An increase in aminotransferase levels was observed in 2 recipients with viremia and 3 recipients with DNAemia. Recipients with liver cirrhosis caused by hepatitis B virus or hepatitis C virus infection as the underlying disease were more likely to have HHV‐6 infection ( P = 0.025). Mortality at the last follow‐up in recipients with HHV‐6 reactivation was significantly higher than in those without viral reactivation ( P = 0.0118). Plasma interleukin‐6 levels were significantly higher in the recipients with HHV‐6 viremia than in the recipients without viremia at 4 weeks post‐transplant ( P = 0.0411). Moreover, tumor necrosis factor α levels were also higher in recipients with HHV‐6 viremia ( P < 0.0001) or reactivation ( P = 0.0011) than in recipients without viremia or reactivation 4 weeks post‐transplant. Liver Transpl, 2007. © 2007 AASLD.