Division of Clinical Virology, Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
J Clin Virol. 2013 Oct;58(2):422-6. doi: 10.1016/j.jcv.2013.07.014. Epub 2013 Aug 12.
Human herpesvirus-6 (HHV-6) frequently reactivates in immunocompromized individuals. Most commonly HHV-6 DNA is detected without organ localized disease. This HHV-6 DNAemia usually occurs in patients who also have CMV reactivations. The question if reactivation of one virus causes reactivation of the other, or whether both viruses reactivate independently, cannot be answered in populations with high seroprevalence for both viruses. Our study is the first in which 35 patients have been included who were CMV seronegative prior to transplantation.
We investigated the occurrence of HHV-6 reactivations in relation to the CMV-serostatus of renal transplantation donor and recipient.
9 consecutive patients receiving a renal transplantation were included. All available stored whole blood samples were tested for HHV-6 DNA by quantitative PCR. Details including CMV serostatus of donor and recipient were recorded.
CMV-seropositive recipients have a 68% chance of developing HHV-6 DNAemia if the kidney came from a CMV-seropositive donor, compared to 26% if the kidney came from a CMV-seronegative donor. CMV-seronegative recipients, who are bound to undergo primary CMV infections following transplantation with a renal graft from a CMV-seropositive donor, have 88% chance of developing HHV-6 DNAemia. If they receive a graft from a CMV-seronegative donor the chance of developing HHV-6 DNAemia is 22%.
Receiving a renal transplant from a CMV-seropositive donor increases the chance of developing HHV-6 DNAemia. HHV-6 DNAemia is a sign of impending primary CMV infections following sero-discordant renal transplantations.
人类疱疹病毒-6（HHV-6）在免疫功能低下的个体中经常重新激活。最常见的是在没有器官定位疾病的情况下检测到 HHV-6 DNA。这种 HHV-6 DNA 血症通常发生在同时存在 CMV 再激活的患者中。无法回答一种病毒的重新激活是否会导致另一种病毒的重新激活，或者两种病毒是否独立重新激活，在两种病毒血清流行率高的人群中。我们的研究是第一个纳入 35 名在移植前 CMV 血清阴性的患者的研究。
我们调查了肾移植供体和受者 CMV 血清状态与 HHV-6 再激活的发生之间的关系。
纳入了 9 例连续接受肾移植的患者。通过定量 PCR 检测所有可用的储存全血样本中的 HHV-6 DNA。记录了包括供体和受者 CMV 血清状态在内的详细信息。
CMV 血清阳性的受者如果肾脏来自 CMV 血清阳性的供者，发生 HHV-6 DNA 血症的几率为 68%，如果肾脏来自 CMV 血清阴性的供者，几率为 26%。CMV 血清阴性的受者在接受来自 CMV 血清阳性供者的肾移植物后，必然会发生原发性 CMV 感染，发生 HHV-6 DNA 血症的几率为 88%。如果他们接受来自 CMV 血清阴性供者的移植物，发生 HHV-6 DNA 血症的几率为 22%。
从 CMV 血清阳性供者接受肾移植会增加发生 HHV-6 DNA 血症的几率。HHV-6 DNA 血症是血清不一致性肾移植后发生原发性 CMV 感染的迹象。
