Prevalence of human herpesviruses in biliary fluid and their association with biliary complications after liver transplantation

Abstract

Background Beta-herpesviruses are common opportunistic pathogens that cause morbidity after liver transplantation (LT). Methods Objective of the study was to evaluate the prevalence and correlation of herpesviruses in bile, blood and liver tissue and to investigate their association with biliary complications and retransplantation (re-LT) free survival after LT. The study design is a single-center case-control study. We performed quantative polymerase chain reaction (qPCR) for herpesvirus 1–8 DNA in bile, blood and liver tissue of 73 patients after first LT and analyzed their clinical courses retrospectively. Results The median follow-up was 48 months (range 2–102), during which a total of 16 patients underwent re-LT and 11 patients died. Of the patients, 46.5% received valganciclovir prophylaxis at the time of bile sample acquisition. Cytomegalovirus (CMV) (18.3%), human herpesvirus 6 (HHV-6) (34.2%), human herpesvirus 7 (HHV-7) (20.5%) and Epstein-Barr virus (EBV) (16.4%) were highly prevalent in bile after LT, while herpes simpex virus 1 and 2 (HSV-1, HSV-2), varicella-zoster virus (VZV) and human herpesvirus 8 (HHV-8) were not or rarely detected in bile. Valganciclovir prophylaxis did not reduce the prevalence of HHV-6 and HHV-7 in bile, but it did reduce the presence of CMV and EBV. The presence of HHV-6 in bile was associated with non-anastomotic biliary strictures (NAS) and acute cellular rejection (ACR). Conclusions CMV, EBV, HHV-6 and HHV-7 are more prevalent in biliary fluid than in liver biopsy or blood serum after LT. HHV-6 and HHV-7 might be associated with biliary complications after LT. Biliary fluids might be an attractive target for routine herpesvirus detection.

Molecular Detection of Human Herpes Viruses in Suspected Measles Serum Samples from Senegal, 2014 to 2017

“…This overall prevalence is consistent with reports from other studies 15,18 but lower than rates reported in previous works conducted in other geographical areas, including Mexico with 20% 19 and Germany with 16.4%. 20 Consistent with many other results, 10,16,21 the detection rates of CMV (6.6%), HHV6 (2.6%), and HSV (0.2%) were relatively low.…”

Human herpesvirus 6B encephalitis in a liver transplant recipient: A case report and review of the literature

“…The indirect adverse effect of HHV‐6 infection on liver transplantation has been studied. HHV‐6 positivity in blood or bile was associated with the incidence of liver allograft rejection 10‐12 . In liver transplantation recipients, HHV‐6 infection also results in increased risks of severe opportunistic infections, including CMV, EBV, VZV, mycobacterial disease, and invasive fungal infections 3,13 .…”

Primary sclerosing cholangitis as an independent risk factor for cytomegalovirus infection after liver transplant

“…Analysis of prevalence of CMV in bile ducts is part of recent investigations. 19 Halme et al reported that CMV infection is a risk factor for the development of biliary complications after LT, 20 and Gotthardt et al found that CMV DNA was detected more frequently in the bile of LT patients with nonanastomotic biliary lesions. 21 CMV was also reported to be a risk factor for the recurrence of PSC after living-donor LT. 22 Even though the correlation between CMV and biliary complications has not been confirmed in all studies and is controversial, [23][24][25] there still is increasing evidence of an association between CMV and biliary diseases, an association that was confirmed in the present study.…”