Human Herpesvirus 6 Seronegativity Before Transplantation Predicts the Occurrence of Fungal Infection in Liver Transplant Recipients

Abstract

These results suggest that HHV-6 seronegativity before transplantation is a valuable clinical marker that identifies patients at risk for developing fungal infection after transplantation.

The impact of human herpesvirus-6 and -7 infection on the outcome of liver transplantation

“…The principal indirect effect of HHV-6 and HHV-7 infection in association with organ transplantation results from their potential to exacerbate CMV infection and disease 32,[43][44][45][46] and their influence on the occurrence of other opportunistic infections such as invasive fungal disease. 33,34 These indirect effects of HHV-6 and HHV-7 infection are partly influenced by their impact on the host immune system. [47][48][49][50] All the three ␤-herpesviruses share tropism for immune cells, a feature that may likely play an important part in the immunomodulating properties of these viruses.…”

“…Using a serologic assay 34 and a sensitive semiquantitative PCR assay, 32 our group raised the potential interaction between the ␤-herpesviruses after transplantation. Primary and secondary HHV-6 seroconversion after liver transplantation was found to be associated with predisposition to invasive and symptomatic CMV infection, particularly in CMV-seropositive recipients of organs from CMV-seropositive donors.…”

“…[27][28][29][30] In addition, many studies in kidney and liver transplant recipients have inferred that the interaction of HHV-6 and/or HHV-7 with CMV and their immune modulating properties are the more important factors in their illness-causing potential, 31,32 as suggested indirectly by the increased predisposition to other opportunistic infection. 33,34 As more scientific data based on many in vitro and in vivo observations are gathered through the years, it is becoming evident that these viruses are emerging pathogens or copathogens after transplantation. Consequent to this increasing appreciation of their potential impact on transplantation outcomes, their pathogenesis during the posttransplantation period, the methods for their diagnosis, and the evaluation of antiviral drugs and strategies for their prevention and treatment are now the subject of many investigations.…”

Human herpesvirus 6 infection in adult living related liver transplant recipients

“…In addition to cytomegalovirus (CMV), a well-known pathogen in immunocompromised patients, it has been proposed that human herpesvirus 6 (HHV-6) is also an opportunistic pathogen in liver transplant recipients. 1,2 Many investigators have studied the clinical features of HHV-6 infection in liver transplant recipients, using viral isolation, [3][4][5][6][7][8][9] antigenemia assay, [10][11][12][13][14] serological analysis, 15,16 and molecular analysis such as real-time polymerase chain reaction (PCR). [17][18][19][20][21][22] Several clinical features, including fever, 5,6,8,10 encephalitis, 7,23 CMV disease, 15,17,18 fungal infection, 7 graft dysfunction, 10,11,22 and hepatitis C virus (HCV) recurrence 9,19 after transplantation, have been suggested as clinical manifestations due to HHV-6 infection.…”

Cytomegalovirus infection in the brain of liver transplant recipients: Do pathologically occult infections matter clinically?

“…9 An unrecognized human herpes virus-6 infection may have influenced these outcomes, as has been previously shown in liver transplant population. 10 However, it should be emphasized that this is an autopsy study and may have likely selected subjects that may be severely ill before to their deaths. Stress associated with severe illness may have caused or enhanced the reactivation of CMV.…”