Human herpesvirus 6 seronegativity before transplantation predicts the occurrence of fungal infection in liver transplant recipients

David H. Dockrell, Julio C. Mendez, Mary Jones, William S. Harmsen, Duane M. Ilstrup, Thomas F. Smith, Russell H. Wiesner, Ruud A.F. Krom, Carlos V. Paya

Research output: Contribution to journalArticlepeer-review

73 Scopus citations

Abstract

Background. Invasive fungal infection has a major impact on the morbidity and mortality of liver transplant recipients. Human herpesvirus (HHV)-6 infection after transplantation is associated with an immunosuppressive state and the development of cytomegalovirus disease. Because cytomegalovirus infection is a risk factor for invasive fungal infection after transplantation, we have examined whether HHV-6 and fungal infection are associated after transplantation. Methods. Pretransplantation sera from 247 consecutive liver transplant recipients were analyzed for IgG to HHV-6. Thirty-three (13%) HHV-6-seronegative recipients were identified. Six of 33 (18%) seronegative recipients experienced fungal infection as compared with 15 of 214 (7%) seropositive recipients (P=0.034). Results. In a univariate analysis of risk factors for fungal infection, pretransplantation seronegativity to HHV-6 (P=0.034), intraoperative cryoprecipitate requirements greater than the 75th percentile (P=0.035), reoperation (P=0.005), biliary stricturing postoperatively (P=0.046), and gastrointestinal or vascular complications postoperatively (P=0.030) were identified as significant risk factors. Moreover, in pairwise multivariate analysis, pretransplantation HHV-6 seronegativity remained a significant variable even in the presence of each of the other variables. Conclusions. 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.

Original languageEnglish (US)
Pages (from-to)399-403
Number of pages5
JournalTransplantation
Volume67
Issue number3
DOIs
StatePublished - Feb 15 1999

ASJC Scopus subject areas

  • Transplantation

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