Prevalence and clinical significance of human herpesviruses 6 and 7 active infection in pediatric liver transplant patients

Ariel E. Feldstein, Raymund R Razonable, Thomas G. Boyce, Deborah K. Freese, Mounif El-Youssef, Jean Perrault, Carlos V. Paya, Michael B. Ishitani

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Recent studies in adult liver transplant patients have suggested that both human herpesvirus (HHV)-6 and HHV-7 infection are important causes of morbidity following liver transplantation. However, the impact of HHV-6 and -7 infection in pediatric liver transplant patients remains largely unknown. The aims were to determine the prevalence of HHV-6 and -7 infection in pediatric liver transplant patients and to determine whether there is an association between HHV-6 and -7 infection with episodes of graft rejection and cytomegalovirus (CMV) infection. A total of 46 pediatric liver transplant patients transplanted at Mayo Clinic between January 1994 and January 2000 were evaluated. Quantitative polymerase chain reaction (PCR) assays for CMV, HHV-6 and HHV-7 were performed on stored sera obtained prior to transplant, weekly for 8 wk and at 4 months and 1 yr post-transplant. Pretransplant sera were tested for HHV-6 antibodies by indirect immunofluorescence assay. A total of 215 blood samples were tested (mean 6.5 ± 3.1, range 3-18). CMV infection occurred in 11 of 33 (33.3%) patients, while CMV disease occurred in 4 of 33 (12%) patients. Infection with HHV-6 (variant B) was detected in three of 33 (9.1%) patients. HHV-7 infection was not detected. Case 1 and 2 were infants (10- and 11-month old, respectively). Both were seronegative for HHV-6 pretransplant. In both cases, HHV-6 infection was associated with concurrent episodes of moderate to severe acute graft rejection. Case 3 was a 16-yr-old girl who was seropositive for HHV-6 pretransplant. No clinical events were recorded and a liver biopsy performed per protocol showed no evidence of rejection. None of the three patients had concomitant CMV infection or disease. In this study, HHV-6 infection occurred in 9% of pediatric liver transplant patients while HHV-7 was not detected. A potential association between primary HHV-6 infection and allograft rejection warrants further investigation.

Original languageEnglish (US)
Pages (from-to)125-129
Number of pages5
JournalPediatric Transplantation
Volume7
Issue number2
DOIs
StatePublished - Apr 2003

Fingerprint

Human Herpesvirus 7
Human Herpesvirus 6
Pediatrics
Transplants
Liver
Herpesviridae Infections
Infection
Cytomegalovirus Infections
Graft Rejection
Cytomegalovirus
Indirect Fluorescent Antibody Technique
Serum
Liver Transplantation

Keywords

  • Cytomegalovirus
  • Human herpesvirus-6
  • Human herpesvirus-7
  • Pediatrics
  • Rejection

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Transplantation

Cite this

Prevalence and clinical significance of human herpesviruses 6 and 7 active infection in pediatric liver transplant patients. / Feldstein, Ariel E.; Razonable, Raymund R; Boyce, Thomas G.; Freese, Deborah K.; El-Youssef, Mounif; Perrault, Jean; Paya, Carlos V.; Ishitani, Michael B.

In: Pediatric Transplantation, Vol. 7, No. 2, 04.2003, p. 125-129.

Research output: Contribution to journalArticle

Feldstein, Ariel E. ; Razonable, Raymund R ; Boyce, Thomas G. ; Freese, Deborah K. ; El-Youssef, Mounif ; Perrault, Jean ; Paya, Carlos V. ; Ishitani, Michael B. / Prevalence and clinical significance of human herpesviruses 6 and 7 active infection in pediatric liver transplant patients. In: Pediatric Transplantation. 2003 ; Vol. 7, No. 2. pp. 125-129.
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