Thomasini R L, Sampaio A M, Bonon S H A, Boin I F S, Leonardi L S, Leonardi M, Costa S C B
Department of Pharmacology, State University of Campinas, 13081-970 Campinas, São Paulo, Brazil.
Transplant Proc. 2007 Jun;39(5):1537-9. doi: 10.1016/j.transproceed.2006.12.037.
We herein have described HCMV and HHV-7 detection during the follow-up of 29 adult liver recipients in our transplant unit. For basic immunosuppression, the patients received cyclosporine and symptomatic HCMV infection was treated with gancyclovir. The most prevalent etiology for liver transplantation was hepatitis C or alcohol abuse (45% of patients). The laboratory monitoring to 180 days after transplantation was performed by nested-polymerase chain reaction to HCMV or HHV-7. HCMV DNA was detected in 19/29 of patients (65.5%) and HHV-7 DNA, in 14/29 of patients (48.2%). The time-related appearance of HHV-7 and HCMV DNA differed significantly (P = .02); their detection was considered independent (P = .2). The results showed that few patients remained free of HHV-7 or HCMV after liver transplantation, indicating that most patients were actively infected with more then one virus sequentially and not concurrently. Graft dysfunction, fever, gastrointestinal system abnormalities, and interstitial pneumonitis dominated the clinical pictures. Thirteen of 29 patients (44.8%) developed symptomatic HCMV active infections. The relationship between the detection of HCMV DNA, and HCMV disease development was significant (P = .0004). In HCMV-free patients, no symptoms or significant laboratory findings were linked with HHV-7. However, HHV-7 was frequently detected sequentially after HCMV, and an interaction of HCMV and/or HHV-6 to increase their pathogenic effects could not be excluded. Further studies should be performed including HHV-6 to evaluate the relationship, among beta herpesviruses.
我们在此描述了在我们移植单元对29名成年肝移植受者进行随访期间对人巨细胞病毒（HCMV）和人疱疹病毒7型（HHV - 7）的检测情况。对于基础免疫抑制，患者接受环孢素治疗，有症状的HCMV感染用更昔洛韦治疗。肝移植最常见的病因是丙型肝炎或酒精滥用（占患者的45%）。移植后180天内通过巢式聚合酶链反应检测HCMV或HHV - 7进行实验室监测。19/29的患者（65.5%）检测到HCMV DNA，14/29的患者（48.2%）检测到HHV - 7 DNA。HHV - 7和HCMV DNA出现的时间相关性差异显著（P = 0.02）；它们的检测被认为是独立的（P = 0.2）。结果表明，肝移植后很少有患者未感染HHV - 7或HCMV，这表明大多数患者先后被不止一种病毒活跃感染，而非同时感染。移植物功能障碍、发热、胃肠道系统异常和间质性肺炎是主要临床表现。29名患者中有13名（44.8%）发生了有症状的HCMV活动性感染。HCMV DNA检测与HCMV疾病发生之间的关系显著（P = 0.0004）。在未感染HCMV的患者中，没有症状或显著的实验室检查结果与HHV - 7相关。然而，HHV - 7经常在HCMV之后被相继检测到，并且不能排除HCMV和/或HHV - 6相互作用以增强其致病作用。应进行包括HHV - 6在内的进一步研究，以评估β疱疹病毒之间的关系。
