Co-infection and clinical impact of human herpesvirus 5 and 6 in liver transplantation
| Autor: | A.N. Sasaki, A.M. Sampaio, Sandra Helena Alves Bonon, A.C. Guardia, S.C. Botelho Costa, Ilka de Fátima Santana Ferreira Boin, A. Milan, Raquel Silveira Bello Stucchi, Paula Nobre de Andrade |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Adult
Graft Rejection medicine.medical_specialty Time Factors Adolescent medicine.medical_treatment viruses Biopsy Herpesvirus 6 Human Cytomegalovirus Roseolovirus Infections Liver transplantation Antibodies Viral Gastroenterology Polymerase Chain Reaction Risk Assessment Organ transplantation Young Adult Predictive Value of Tests Risk Factors Internal medicine medicine Humans Prospective Studies Aged Hepatitis Transplantation Chi-Square Distribution business.industry Coinfection virus diseases Immunosuppression Bacterial Infections Middle Aged Viral Load medicine.disease Liver Transplantation Virus Latency Treatment Outcome Immunology Acute Disease Cytomegalovirus Infections Surgery Virus Activation business Viral load |
| Zdroj: | Transplantation proceedings. 44(8) |
| ISSN: | 1873-2623 |
| Popis: | Background. Human herpesvirus (HHV) 5 and 6 remain latent after primary infection and can be reactivated after immunosuppression for organ transplantation. An association between HHV-5 and HHV-6 has been reported in liver transplant patients. The coinfection is associated with clinical manifestations and graft dysfunction. Objective. The aim of this study was to monitor herpesviruses in liver transplant recipients to better understand issues involving coinfection with HHV-5/6 and correlations with acute cellular rejection episodes and bacterial infections. Methods. Forty-five adult liver transplant patients of median age 47 years (range, 18‐66), gave blood samples and liver biopsies in the first 6 months after their surgeries. Viremia was detected with the use of nested PCR and antigenemia; the Banff classification was used to detect allograft rejection. Results. IgG positive for HHV-5 was observed in 94% of subjects whose main indication (67%) for transplantation was hepatitis C. Twenty-three (51.1%) displayed cytomeg virus (CMV) infections and 12 (26.7%) HHV-6 infection. There were 6 patients (13.3%) with HHV-5/6 coinfections. Eighteen of the 23 patients had CMV disease, showing a strong correlation between a positive test and CMV disease; 6 displayed an acute cellular rejection episode in the same period ( 2 6.62; P .03). Four out of 6 patients who displayed coinfections (HHV-5/6) had concomitant bacterial infections; 3/6 experienced graft rejection episodes. During follow-up, 1 patient had HHV-6 infection diagnosed as encephalitis followed by fever on the 24th day after surgery. The median 32 days for HHV-6 detection by nested PCR positivity was shorter than 38 days for HHV-5. Conclusions. HHV-5/6‐infected patients displayed more allograft rejection episodes, coinfections, and concomitant bacterial infections, besides an higher risk for CMV disease. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect