Lehto Juho T, Halme Maija, Tukiainen Pentti, Harjula Ari, Sipponen Jorma, Lautenschlager Irmeli
Department of Medicine, Division of Respiratory Diseases, Helsinki University Central Hospital, Helsinki, Finland.
J Heart Lung Transplant. 2007 Jan;26(1):41-7. doi: 10.1016/j.healun.2006.10.017.
The impact of herpesvirus-6 and -7 (HHV-6, HHV-7) activation in lung transplant recipients is still poorly understood. We report the appearance of HHV-6 and HHV-7 antigenemia after lung transplantation and evaluate the efficacy of anti-viral drugs against these viruses.
Twenty-two lung or heart-lung recipients were monitored for HHV-6, HHV-7 and cytomegalovirus (CMV) during 12 post-operative months. HHV-6- and HHV-7-specific antigens and CMV pp65 antigens were analyzed in blood leukocytes and bronchoalveolar lavage fluid cells by monoclonal antibodies. Ganciclovir or valganciclovir prophylaxis for a minimum of 3 months was given to 19 recipients at risk for CMV infection.
HHV-6, HHV-7 and CMV antigenemia was detected in 20 (91%), 11 (50%) and 12 (55%) recipients (median 16, 31 and 165 days) after transplantation, respectively. HHV-6 antigenemia occurred in 15 (79%), HHV-7 antigenemia in 7 (37%) and CMV antigenemia in 1 (7%) of these patients during anti-viral prophylaxis. HHV-6 or HHV-7 antigenemia was frequently associated with CMV antigenemia, which was detected 3 to 12 months after transplantation. Ganciclovir or valganciclovir treatment of CMV infection was effective against the concomitant HHV-6 and HHV-7 antigenemia in 9 of 12 (75%) and 5 of 6 (83%) cases, respectively. One case of pneumonitis and 1 of encephalitis were temporally associated with HHV-6. No other clinical manifestations could be linked solely to HHV-6 or -7.
HHV-6 and -7 antigenemia was common and appeared early after lung transplantation. CMV prophylaxis was not able to prevent the appearance of HHV-6 and -7 antigenemia.
肺移植受者中疱疹病毒6型和7型（HHV - 6、HHV - 7）激活的影响仍知之甚少。我们报告了肺移植后HHV - 6和HHV - 7抗原血症的出现情况，并评估了抗病毒药物对这些病毒的疗效。
对22例肺或心肺移植受者在术后12个月内监测HHV - 6、HHV - 7和巨细胞病毒（CMV）。通过单克隆抗体分析血液白细胞和支气管肺泡灌洗细胞中的HHV - 6和HHV - 7特异性抗原以及CMV pp65抗原。对19例有CMV感染风险的受者给予至少3个月的更昔洛韦或缬更昔洛韦预防治疗。
移植后分别在20例（91%）、11例（50%）和12例（55%）受者中检测到HHV - 6、HHV - 7和CMV抗原血症（中位时间分别为16、31和165天）。在抗病毒预防治疗期间，这些患者中分别有15例（79%）出现HHV - 6抗原血症，7例（37%）出现HHV - 7抗原血症，1例（7%）出现CMV抗原血症。HHV - 6或HHV - 7抗原血症常与CMV抗原血症相关，CMV抗原血症在移植后3至12个月被检测到。更昔洛韦或缬更昔洛韦治疗CMV感染分别对12例中的9例（75%）和6例中的5例（83%）伴随的HHV - 6和HHV - 7抗原血症有效。1例肺炎和1例脑炎在时间上与HHV - 6相关。没有其他临床表现可单独与HHV - 6或 - 7相关联。
HHV - 6和 - 7抗原血症很常见，且在肺移植后早期出现。CMV预防不能预防HHV - 6和 - 7抗原血症的出现。
