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Primary herpes simplex virus type‐2 infection as a cause of liver failure after liver transplantation
Author(s) -
Nebbia G.,
Mattes F.M.,
Ramaswamy M.,
Quaglia A.,
Verghese G.,
Griffiths P.D.,
Burroughs A.,
Geretti A.M.
Publication year - 2006
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/j.1399-3062.2006.00144.x
Subject(s) - medicine , herpes simplex virus , immunology , virus , antibody , cytomegalovirus , liver transplantation , herpesviridae , virology , hsl and hsv , simplexvirus , transplantation , disease , viral disease , pathology
We report a case of fatal primary herpes simplex virus type‐2 (HSV‐2) infection following liver transplantation, which manifested with fever and liver failure in the absence of muco‐cutaneous disease. The infection was characterized by high levels of HSV DNA in blood and the patient's inability to mount HSV‐specific T‐cell responses while showing preserved T‐cell responses against cytomegalovirus. The donor was HSV‐1 immunoglobulin G (IgG) seronegative and HSV‐2 IgG seropositive, whereas the recipient was HSV‐1 and HSV‐2 IgG seronegative, suggesting that the graft may have been the source of the infection. In HSV‐seronegative recipients of grafts from HSV‐seropositive donors, HSV infection should be included in the differential diagnosis of a febrile illness, regardless of the absence of muco‐cutaneous disease. In this setting, real‐time polymerase chain reaction applied to blood samples provides a sensitive, rapid, and quantitative diagnostic tool.