Härmä Maiju, Höckerstedt Krister, Lyytikäinen Outi, Lautenschlager Irmeli
Department of Surgery, Transplantation and Liver Surgery Clinic, and Transplant Unit Research Laboratory, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
J Med Virol. 2006 Jun;78(6):800-5. doi: 10.1002/jmv.20626.
Betaherpesviruses human herpesvirus-6 and -7 (HHV-6, HHV-7), which are closely related to cytomegalovirus (CMV), have been reported in transplant patients. In this retrospective study, we investigated the occurrence of HHV-6 and HHV-7 antigenemia in relation to symptomatic CMV infection after liver transplantation.
Sample material from 64 adult liver transplant recipients was included in the study. The patients were monitored weekly for CMV, HHV-6, and HHV-7. CMV infections were diagnosed by pp65-antigenemia and viral cultures. Concomitantly HHV-6 and HHV-7 antigens were demonstrated in peripheral blood mononuclear cells by monoclonal antibodies against both variants A and B and immunoperoxidase staining. Altogether 540 post-transplant blood specimens were analyzed.
Nineteen patients (30%) developed symptomatic CMV pp65 antigenemia during the first 3 months (mean 33 days, range 5-62 days) post-transplantation and were treated with intravenous ganciclovir. Concurrent HHV-6 antigenemia was detected in 16/19 (median 9 days, range 6-24 days) and HHV-7 antigenemia 15/19 patients (median 17 days, range 5-58 days) after transplantation. HHV-6 appeared before CMV in most cases (12/16), HHV-7 usually together with CMV. In those cases that HHV-6 preceded CMV antigenemia, it also was a possible cause of graft dysfunction. HHV-7 and CMV were so closely overlapping, that no symptoms could solely be linked with HHV-7.
HHV-6 and HHV-7 antigenemia usually occurred together with symptomatic CMV infection after liver transplantation. HHV-6 preceded CMV, but HHV-7 appeared together with CMV. Further investigation of the clinical significance of HHV-6 and HHV-7 antigenemia in organ transplant patients is necessary.
与巨细胞病毒（CMV）密切相关的β疱疹病毒人类疱疹病毒6型和7型（HHV-6、HHV-7）已在移植患者中被报道。在这项回顾性研究中，我们调查了肝移植后HHV-6和HHV-7抗原血症与有症状CMV感染的关系。
64例成年肝移植受者的样本材料被纳入研究。对患者每周监测CMV、HHV-6和HHV-7。CMV感染通过pp65抗原血症和病毒培养进行诊断。同时，通过针对A和B两种变体的单克隆抗体及免疫过氧化物酶染色在外周血单核细胞中检测HHV-6和HHV-7抗原。共分析了540份移植后的血液标本。
19例患者（30%）在移植后的前3个月（平均33天，范围5 - 62天）出现有症状的CMV pp65抗原血症，并接受了静脉注射更昔洛韦治疗。移植后，16/19例（中位数9天，范围6 - 24天）检测到同时存在的HHV-6抗原血症，15/19例患者（中位数17天，范围5 - 58天）检测到HHV-7抗原血症。在大多数情况下（12/16），HHV-6在CMV之前出现，HHV-7通常与CMV同时出现。在HHV-6先于CMV抗原血症出现的那些病例中，它也是移植功能障碍的一个可能原因。HHV-7和CMV重叠非常紧密，以至于没有症状能单独与HHV-7相关联。
肝移植后，HHV-6和HHV-7抗原血症通常与有症状的CMV感染同时发生。HHV-6先于CMV出现，但HHV-7与CMV同时出现。有必要进一步研究HHV-6和HHV-7抗原血症在器官移植患者中的临床意义。
