HUMAN HERPESVIRUS-6 INFECTION AFTER LIVER-TRANSPLANTATION

A diagnosis of posttransplantation human herpesvirus-6 (HHV-6) infecti on was established for eight adult recipients among a liver transplant ation patient population of 121, The diagnosis was based on serology a nd demonstration of HHV-6 specific antigens in liver biopsy specimens with use of monoclonal antibodies and immunoperoxidase staining. A sig nificant graft dysfunction was recorded in association with serodiagno sis. HHV-6 early antigens, as well as HHV-6 variant B antigens, were d etected retrospectively in all six available liver biopsy specimens. H istologic examination of biopsy specimens demonstrated acute rejection in 5 of the 8 patients, and 3 patients had portal lymphocyte infiltra tion. In five cases cytomegalovirus (CMV) infection was associated wit h HHV-6 infection; in four cases CMV antigens were also detected in th e biopsy specimens. Two patients who had pure HHV-6 infection without CMV infection or rejection had significantly impaired graft function, with a positive antigen-detection test. Thus, HHV-6 may infect the liv er allograft and cause graft dysfunction and may possibly be associate d with rejection and/or CMV infection.