PMID- 11889438
OWN - NLM
STAT- MEDLINE
DCOM- 20020402
LR  - 20190713
IS  - 0041-1337 (Print)
IS  - 0041-1337 (Linking)
VI  - 73
IP  - 4
DP  - 2002 Feb 27
TI  - Clinical impact of human herpesvirus 6 infection after liver transplantation.
PG  - 599-604
AB  - BACKGROUND: Reactivation of human herpesvirus 6 (HHV-6) appears to be common 
      after transplant. Viral reactivation may result in febrile illness and may also 
      play an immunomodulatory role that leads to indirect effects such as 
      opportunistic infections and rejection. The objective of this study was to 
      determine the clinical impact of HHV-6 infection after liver transplantation 
      including both direct and indirect effects. METHODS: This was a prospective 
      single center cohort study of 200 consecutive patients undergoing liver 
      transplantation. Systemic serial HHV-6 viral load measurements and all clinical 
      outcomes including development of opportunistic infections, cytomegalovirus (CMV) 
      disease, and rejection were determined. RESULTS: HHV-6 infection (defined as 
      viral load > or = 2 log10 copies/microg input DNA) occurred in 56/200 (28%) 
      patients. Symptomatic disease attributable to HHV-6 alone occurred in 2/200 (1%) 
      patients. Univariate analysis revealed HHV-6 infection was associated with the 
      development of opportunistic infection and CMV disease. In a multivariate 
      analysis designed to control for the level of immunosuppression, the risk of 
      opportunistic infection increased by 3.68-fold in patients with HHV-6 infection 
      (95% confidence interval [CI], 1.86-7.27; P=0.001). In a similar multivariate 
      analysis, the risk of CMV disease increased by 3.59-fold in patients with HHV-6 
      infection (95% CI, 1.53-8.44; P=0.003). HHV-6 infection was not associated with 
      rejection except in the subgroup of patients with rejection after 30 days 
      posttransplant (odds ration 2.27; 95% CI, 1.09-4.77; P=0.029). CONCLUSIONS: HHV-6 
      reactivation after transplant is common and is associated with the development of 
      opportunistic infections and CMV disease and possibly with a subgroup of acute 
      rejection episodes. HHV-6 infection likely has a significant impact in transplant 
      recipients through indirect effects of viral replication.
FAU - Humar, Atul
AU  - Humar A
AD  - Toronto General Hospital, Toronto, Ontario, Canada, M5G 2C4. 
      Atul.Humar@uhn.on.ca.
FAU - Kumar, Deepali
AU  - Kumar D
FAU - Caliendo, Angela M
AU  - Caliendo AM
FAU - Moussa, George
AU  - Moussa G
FAU - Ashi-Sulaiman, Aisha
AU  - Ashi-Sulaiman A
FAU - Levy, Gary
AU  - Levy G
FAU - Mazzulli, Tony
AU  - Mazzulli T
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
RN  - 0 (DNA, Viral)
SB  - IM
MH  - Adult
MH  - Analysis of Variance
MH  - Cytomegalovirus Infections/epidemiology
MH  - DNA, Viral/blood
MH  - *Herpesvirus 6, Human/growth & development
MH  - Humans
MH  - Liver Transplantation/*physiology
MH  - Opportunistic Infections/epidemiology
MH  - Polymerase Chain Reaction
MH  - Postoperative Complications/epidemiology
MH  - Roseolovirus Infections/*epidemiology
MH  - Viral Load
MH  - Virus Activation
EDAT- 2002/03/13 10:00
MHDA- 2002/04/03 10:01
CRDT- 2002/03/13 10:00
PHST- 2002/03/13 10:00 [pubmed]
PHST- 2002/04/03 10:01 [medline]
PHST- 2002/03/13 10:00 [entrez]
AID - 10.1097/00007890-200202270-00021 [doi]
PST - ppublish
SO  - Transplantation. 2002 Feb 27;73(4):599-604. doi: 
      10.1097/00007890-200202270-00021.