Humar A, Malkan G, Moussa G, Greig P, Levy G, Mazzulli T
Department of Medicine, Division of Infectious Diseases and Multi-Organ Transplantation, Toronto General Hospital-University Health Network, Toronto, Ontario M5G 2C4, Canada.
J Infect Dis. 2000 Apr;181(4):1450-3. doi: 10.1086/315391. Epub 2000 Apr 13.
Human herpesvirus-6 (HHV-6) may be a risk factor for cytomegalovirus (CMV) disease in posttransplant patients, possibly through a direct interaction or through a general immunomodulatory effect. To examine this possibility, 88 liver transplant recipients were monitored with serial HHV-6 polymerase chain reaction (PCR), CMV antigenemia, and CMV plasma viral load. HHV-6 infection was defined by a positive PCR of peripheral blood lymphocytes. Forty-eight (54.4%) of 88 patients had at least 1 positive HHV-6 PCR. CMV recurrence was significantly more common in patients with HHV-6 infection (38/48 patients [79. 2%]), compared with recurrence in those without HHV-6 infection (18/40 patients [45%]; P=.001). Peak CMV viral load was 24, 147+/-6799 copies/mL in patients with HHV-6 infection versus 8391+/-4598 copies/mL in patients without HHV-6 infection (P=.001). Symptomatic CMV disease was more common in patients with HHV-6 infection than it was in those without infection (15/48 patients [31. 3%] vs. 4/10 patients [10.0%]; P=.013). In a multivariate analysis including other risk factors for CMV, HHV-6 infection remained an independent risk factor for CMV disease (P=.013; odds ratio, 7.26; 95% confidence interval, 1.52-34.72). HHV-6 is associated with CMV infection and disease, thus supporting an interaction between these viruses.
人疱疹病毒6型（HHV - 6）可能是移植后患者发生巨细胞病毒（CMV）疾病的一个危险因素，可能是通过直接相互作用或通过一般的免疫调节作用。为了检验这种可能性，对88例肝移植受者进行了连续的HHV - 6聚合酶链反应（PCR）、CMV抗原血症和CMV血浆病毒载量监测。HHV - 6感染通过外周血淋巴细胞PCR阳性来定义。88例患者中有48例（54.4%）至少有1次HHV - 6 PCR阳性。与未感染HHV - 6的患者（18/40例患者[45%]）相比，HHV - 6感染患者的CMV复发明显更常见（38/48例患者[79.2%]；P = 0.001）。HHV - 6感染患者的CMV病毒载量峰值为24147±6799拷贝/毫升，而未感染HHV - 6的患者为8391±4598拷贝/毫升（P = 0.001）。有症状的CMV疾病在HHV - 6感染患者中比未感染患者更常见（15/48例患者[31.3%]对4/10例患者[10.0%]；P = 0.013）。在包括其他CMV危险因素的多变量分析中，HHV - 6感染仍然是CMV疾病的独立危险因素（P = 0.013；比值比，7.26；95%置信区间，1.52 - 34.72）。HHV - 6与CMV感染和疾病相关，因此支持了这些病毒之间的相互作用。
