Human herpesvirus 6 infection after living related liver transplantation

The aim of the study was to investigate human herpesvirus-6 (HHV-6) infecti on after liver transplantation from living related donors, and to evaluate the reliability of the presence of HHV-6 DNA in plasma by the polymerase ch ain reaction (PCR) for monitoring active HHV-6 infection. EDTA peripheral b lood was collected from 47 donor and recipient (16 males and 31 females, ag e 1-320 months) pairs at the time of transplantation and biweekly from thes e recipients after transplantation until 2 months after operation. Isolatio n of HHV-6 and serological assays were carried out to evaluate active HHV-6 infection in this study. The presence of the viral DNA in plasma was teste d by nested PCR. Four clinical events, such as unexplained fever, thrombocy topenia, rejection, and central nervous system (CNS) involvement, were eval uated for clinical features of the virus infection. Risk factors for the vi rus activity after liver transplantation were also examined. HHV-6 activity was detected in 23 (49%) of the 47 recipients approximately 2-4 weeks afte r transplantation. All 9 isolates were HHV-6 variant B. The presence of the viral DNA in plasma correlated well with virus isolation and serology (P< 0.01). Only unexplained fever was associated statistically with HHV-6 activ ity after liver transplantation (P< 0.01). if the recipient was seronegativ e to HHV-6 before transplantation, the recipient was more likely to develop the active virus infection after liver transplantation (P = 0.11). HHV-6 a ctivity occurred in one-half of the recipients approximately 2-4 weeks afte r liver transplantation, and there was a close association between HHV-6 ac tivity and unexplained fever following transplantation. Detection of the vi ral DNA in plasma by PCR is useful for monitoring active HHV-6 infection in these patients. Seronegative recipients were more likely to have evidence of active HHV-6 infection after liver transplantation. J. Med. Virol. 62:52 -59, 2000. (C) 2000 Wiley-Liss, Inc.