Human Herpesvirus 6 as an Indicator of Cytomegalovirus Infection and Its Attributable Disease Symptoms in Liver Transplant Recipients

Jamalidoust, Marzieh; Aliabadi, Nasrin; Namayandeh, Mandana; Ziyaeyan, Mazyar

doi:10.6002/ect.2019.0119

Cited by 4 publications

(10 citation statements)

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“…Human cytomegalovirus infection is a life-threatening infection in immunocompromised patients, especially HIV sufferers and organ transplant recipients (3,4). Despite much advancement in controlling CMV infection since the first successful liver transplantation in 1967, the virus had remained as the most important pathogen influencing the outcome of liver transplantation (5,6). Human cytomegalovirus infection can significantly increase morbidity and mortality rates among transplant patients.…”

Section: Introductionmentioning

confidence: 99%

“…Human cytomegalovirus infection can significantly increase morbidity and mortality rates among transplant patients. Depending on interrelated factors such as donor and recipient match, serological status, immunosuppressive drug regimes, the overall functionality of innate/acquired immunity system, and CMV viral factors, the incidence of CMV infection in such patients varies (6,7). It is estimated that 16-47% of all liver transplant patients develop CMV diseases (6).…”

Section: Introductionmentioning

confidence: 99%

“…Depending on interrelated factors such as donor and recipient match, serological status, immunosuppressive drug regimes, the overall functionality of innate/acquired immunity system, and CMV viral factors, the incidence of CMV infection in such patients varies (6,7). It is estimated that 16-47% of all liver transplant patients develop CMV diseases (6). Universal prophylaxis and preemptive therapy are the primary approaches to preventing direct and indirect adverse CMV effects as well as associated diseases induced by liver transplantation (8).…”

Section: Introductionmentioning

confidence: 99%

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Post-Liver Transplant Cytomegalovirus (CMV) Reactivation, Graft, and Patient Survival Rates in Iranian Population

Jamalidoust

Namayandeh

Pouladfar

et al. 2021

Jundishapur J Microbiol

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Background: Human cytomegalovirus (CMV) is the major complication of viral infection in immunocompromised patients. This opportunistic infection is associated with high morbidity and mortality in transplanted recipients. Objectives: The present study aimed to determine CMV burden and assess the clinical outcome in the liver recipients with CMV reactivated infection at Nemazi Hospital, Shiraz, Iran. Methods: This retrospective study examined 657 patients who underwent liver transplantation during 2014 - 2017 to identify the CMV infection, morbidity, and mortality rates. To this end, the medical records of such patients were reviewed, and their rejection/survival rates were analyzed. Accordingly, the CMV infection was diagnosed by Taq-Man real-time PCR assays. Results: In this study, 151 (23%) had CMV reactivation at least one year after liver transplantation. Viremic patients had a viral burden between 300 - 738790 copies/mL. In this study, 41 persons (6.2%) died, and 58 LT patients (8.8%) had rejection experience up to one year after their operation. Among the 41 dead patients, 21 and 20 cases were with and without CMV-reactivation, respectively. The results demonstrated that the mortality rate was significantly higher in the CMV-infected patients than the non-CMV-infected counterparts. In contrast, the graft survival rate was not significantly different between the two groups (P ≤ 0.05). Conclusions: In the present study, CMV infection can serve as a significant mortality predictor in LT patients.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Post-Liver Transplant Cytomegalovirus (CMV) Reactivation, Graft, and Patient Survival Rates in Iranian Population

Jamalidoust

Namayandeh

Pouladfar

et al. 2021

Jundishapur J Microbiol

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“…Diagnosis of these forms of HCMV disease is given by the clinical symptoms plus the molecular detection of HCMV in the relevant organ tissue 72 . The roseoloviruses have been reported to be important risk factors in HCMV disease in both SOT, mainly renal and hepatic, 73–80 and HSCT 81,82 . A 2002 review highlighted the role of HHV6/7 as risk factors associated with HCMV disease 79 .…”

Section: Clinical Evidence: the Association Of Virological Detection ...mentioning

confidence: 99%

“…There are two other liver SOT studies in which 8% and 30% of HCMV/HHV6 co‐detection events were observed, respectively (N = 246 total). The first study reported that HHV6 co‐detection increased 3.59 times the risk of HCMV disease ( p = 0.003), 84 the second that 13 of 14 co‐detection events showed evidence of HCMV disease (RR estimated of 7.4‐fold, p = 0.0001) 80 . Similar findings have been reported in renal transplantation (N = 53), in which HHV6 co‐detection was associated with HCMV syndrome ( p = 0.003), and severe HCMV disease ( p = 0.085) 73 …”

Section: Clinical Evidence: the Association Of Virological Detection ...mentioning

confidence: 99%

Molecular and immune interactions between β- and γ-herpesviruses in the immunocompromised host

Sánchez-Ponce

Fuentes‐Pananá

2022

Journal of Leukocyte Biology

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βand γ-herpesviruses persistently infect most of the world population, largely without clinical manifestations. However, in immunosuppressive settings like transplantation, these viruses are often jointly reactivated, associating with graft dysfunction/rejection, HCMV disease, and lymphoproliferation. In HIV/AIDS, direct interaction mechanisms have been described for EBV and KSHV in primary effusion lymphoma, demonstrating that the cooperation between both viruses enhances lymphomagenesis. Here, we discuss the clinical evidence supporting that the simultaneous reactivation of these viruses increases the probability of mutual interactions, also providing a conceptual framework explaining how one virus can influence another. Specifically, we propose mechanisms of indirect communication through immune soluble mediators, mainly cytokines, chemokines, and IFN regulatory molecules, based on common features of their infectious cycles and the convergent need on immunomodulatory mechanisms.

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Risk factors and outcome of concurrent and sequential multiviral cytomegalovirus, Epstein–Barr virus, BK virus, adenovirus and other viral reactivations in transplantation

Sim

Yong

Slavin

et al. 2022

Current Opinion in Infectious Diseases

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Purpose of reviewReactivation of viral infections occurs frequently in immunosuppressed populations, particularly in solid organ (SOT) or allogeneic haematopoietic cell (HCT) transplant patients. Concurrent and sequential multivirus infections are common, yet risk factors and outcomes remain unclear. This review aims to identify the patients vulnerable to multivirus infections and characterize the impact of increased viral burden to formulate prevention and treatment strategies. Recent findingsIncidences of up to 89% in SOT and 36% in HCT have been reported for two viruses, and 32% in SOT and 28% in HCT for at least three viruses. Risk factors appear related to an increased burden of immunosuppression, with most viral coinfections occurring within 12 months of transplantation. Direct viral complications such as cytomegalovirus disease are more frequent in coinfected patients, with documented prolonged duration of viraemia, higher viral load and increased end-organ disease. Graft dysfunction, acute rejection and graft-vs.-host disease (GVHD) have also been associated. Increased mortality is reported in the HCT population. SummaryMultivirus infections occur in a significant proportion of transplant patients and is linked to immunosuppressive burden. There is increasing evidence that this leads to worse graft and patient outcomes. Further prospective studies are required to further comprehensively characterise viral epidemiology, mechanisms and treatment strategies to ameliorate this risk.

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Human Herpesvirus 6 as an Indicator of Cytomegalovirus Infection and Its Attributable Disease Symptoms in Liver Transplant Recipients

Cited by 4 publications

References 2 publications

Post-Liver Transplant Cytomegalovirus (CMV) Reactivation, Graft, and Patient Survival Rates in Iranian Population

Post-Liver Transplant Cytomegalovirus (CMV) Reactivation, Graft, and Patient Survival Rates in Iranian Population

Molecular and immune interactions between β- and γ-herpesviruses in the immunocompromised host

Risk factors and outcome of concurrent and sequential multiviral cytomegalovirus, Epstein–Barr virus, BK virus, adenovirus and other viral reactivations in transplantation

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