HHV-6 in liver transplantation: A literature review

Tuan L. Phan, Irmeli Lautenschlager, Raymund R Razonable, Flor M. Munoz

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

Human herpesvirus 6 (HHV-6A and HHV-6B) can cause primary infection or reactivate from latency in liver transplant recipients, which can result in a variety of clinical syndromes, including fever, hepatitis, encephalitis and higher rates of graft dysfunction as well as indirect effects including increased risks of mortality, CMV disease, hepatitis C progression and greater fibrosis scores. Although HHV-6 infection is currently diagnosed by quantifying viral DNA in plasma or blood, biopsy to demonstrate histopathological effects of HHV-6 remains the gold standard for diagnosis of end-organ disease. HHV-6 reactivation may be restricted to the infected organ with no evidence of active infection in the blood. HHV-6 infections in liver transplant patients are mostly asymptomatic, but clinically significant tissue-invasive infections have been treated successfully with ganciclovir, foscarnet or cidofovir. Inherited chromosomally integrated HHV-6 (ciHHV-6), in either the recipient or the donor organ, may create confusion about systemic HHV-6 infection. Recipients with inherited ciHHV-6 may have an increased risk of opportunistic infection and graft rejection. This article reviews the current scientific data on the clinical effects, risk factors, pathogenesis, diagnosis and treatment of HHV-6 infections in liver transplant recipients.

Original languageEnglish (US)
JournalLiver International
DOIs
StateAccepted/In press - 2017

Keywords

  • Chromosomally integrated HHV-6 (CIHHV-6)
  • Human herpesvirus 6 (HHV-6)
  • Liver transplantation

ASJC Scopus subject areas

  • Hepatology

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