Premium
Prevalence and clinical significance of human herpesviruses 6 and 7 active infection in pediatric liver transplant patients
Author(s) -
Feldstein Ariel E.,
Razonable Raymund R.,
Boyce Thomas G.,
Freese Deborah K.,
ElYoussef Mounif,
Perrault Jean,
Paya Carlos V.,
Ishitani Michael B.
Publication year - 2003
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1034/j.1399-3046.2003.00028.x
Subject(s) - medicine , human herpesvirus 6 , liver transplantation , cytomegalovirus , gastroenterology , herpesviridae , serology , immunology , betaherpesvirinae , transplantation , human cytomegalovirus , antibody , viral disease , virus
Recent studies in adult liver transplant patients have suggested that both human herpesvirus (HHV)‐6 and HHV‐7 infection are important causes of morbidity following liver transplantation. However, the impact of HHV‐6 and ‐7 infection in pediatric liver transplant patients remains largely unknown. The aims were to determine the prevalence of HHV‐6 and ‐7 infection in pediatric liver transplant patients and to determine whether there is an association between HHV‐6 and ‐7 infection with episodes of graft rejection and cytomegalovirus (CMV) infection. A total of 46 pediatric liver transplant patients transplanted at Mayo Clinic between January 1994 and January 2000 were evaluated. Quantitative polymerase chain reaction (PCR) assays for CMV, HHV‐6 and HHV‐7 were performed on stored sera obtained prior to transplant, weekly for 8 wk and at 4 months and 1 yr post‐transplant. Pretransplant sera were tested for HHV‐6 antibodies by indirect immunofluorescence assay. A total of 215 blood samples were tested (mean 6.5 ± 3.1, range 3–18). CMV infection occurred in 11 of 33 (33.3%) patients, while CMV disease occurred in 4 of 33 (12%) patients. Infection with HHV‐6 (variant B) was detected in three of 33 (9.1%) patients. HHV‐7 infection was not detected. Case 1 and 2 were infants (10‐ and 11‐month old, respectively). Both were seronegative for HHV‐6 pretransplant. In both cases, HHV‐6 infection was associated with concurrent episodes of moderate to severe acute graft rejection. Case 3 was a 16‐yr‐old girl who was seropositive for HHV‐6 pretransplant. No clinical events were recorded and a liver biopsy performed per protocol showed no evidence of rejection. None of the three patients had concomitant CMV infection or disease. In this study, HHV‐6 infection occurred in 9% of pediatric liver transplant patients while HHV‐7 was not detected. A potential association between primary HHV‐6 infection and allograft rejection warrants further investigation.