Confirmation of the low clinical effect of human herpesvirus-6 and -7 infections after renal transplantation

J Med Virol. 2012 Mar;84(3):450-6. doi: 10.1002/jmv.23206.

Abstract

Human herpesvirus-6 and -7 (HHV-6 and HHV-7) may lead to pathological manifestations in renal transplant recipients. The aim of this study was to investigate beta-herpesvirus infections in 50 adult kidney transplant recipients after transplantation to examine the effect, interactions, and pathogenic consequences of infection and the effect of immunosuppressive regimens and Human cytomegalovirus (HCMV) prophylaxis with VACV. Beta-herpesviruses loads in the blood of 50 adult kidney transplant recipients over a 6-month period after transplantation and 198 blood donors were determined using polymerase chain reaction. The rate of HHV-6 detection in peripheral mononuclear cells (PBMCs) was higher in patients with end-stage renal disease and during the post-transplantation follow-up than in healthy subjects (33% and 68% vs. 12%, respectively). The detection rate of HHV-7 in PBMCs was similar between patients, both before grafting and during the follow-up for transplant recipients (69% and 88%, respectively), and healthy subjects (78%), and correlated with the number of lymphocytes. HCMV in plasma was detected only in patients during the post-transplant period (24%). VACV prophylaxis had no negative effect on the replication of HHV-6 or HHV-7, and univariate analyses demonstrated associations between HHV-6 infection and acute graft rejection [Odds ratio (OR) = 2.94, 95% confidence interval (CI), 1.05-8.2, P = 0.04], and between HHV-7 infection and cholestasis [OR = 2.61 (95% CI, 1.08-6.3), P = 0.03]. Immunosuppressive regimens had no effect on beta-herpesviruses infections. This study revealed the differing behavior of HCMV, HHV-6, and HHV-7 in kidney transplant recipients, and confirmed the association of HHV-6 with graft rejection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antiviral Agents / pharmacology
  • Antiviral Agents / therapeutic use
  • Cytomegalovirus / drug effects
  • Cytomegalovirus / immunology
  • Cytomegalovirus / isolation & purification*
  • Cytomegalovirus Infections / complications
  • Cytomegalovirus Infections / drug therapy
  • Cytomegalovirus Infections / virology
  • DNA, Viral / blood
  • Female
  • Follow-Up Studies
  • Graft Rejection / etiology
  • Herpesvirus 6, Human / drug effects
  • Herpesvirus 6, Human / isolation & purification*
  • Herpesvirus 7, Human / drug effects
  • Herpesvirus 7, Human / isolation & purification*
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / pharmacology
  • Immunosuppressive Agents / therapeutic use
  • Kidney Transplantation* / adverse effects
  • Male
  • Middle Aged
  • Roseolovirus Infections / complications*
  • Roseolovirus Infections / drug therapy
  • Roseolovirus Infections / virology*
  • Treatment Outcome
  • Viral Load
  • Virus Replication / drug effects
  • Young Adult

Substances

  • Antiviral Agents
  • DNA, Viral
  • Immunosuppressive Agents