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Herpes simplex virus hepatitis after solid organ transplantation in adults
S Kusne1, M Schwartz, M K Breinig
1Department of Medicine, Graduate School of Public Health, University of Pittsburgh, Pennsylvania 15261.
The Journal of Infectious Diseases
|May 1, 1991
Summary
Herpes simplex virus (HSV) hepatitis can occur early after solid organ transplantation, leading to high mortality. Early diagnosis and antiviral therapy, potentially including acyclovir prophylaxis, may improve survival rates for this serious post-transplant complication.
Area of Science:
- Hepatology
- Transplantation Immunology
- Virology
Background:
- Herpes simplex virus (HSV) hepatitis is a rare but severe complication following solid organ transplantation.
- It typically manifests earlier than cytomegalovirus (CMV) hepatitis, presenting a diagnostic challenge.
Purpose of the Study:
- To investigate the clinical characteristics, outcomes, and potential preventive strategies for HSV hepatitis in solid organ transplant recipients.
Main Methods:
- Retrospective analysis of twelve solid organ transplant recipients who developed HSV hepatitis.
- Review of clinical manifestations, laboratory findings, pathological findings, and treatment outcomes.
Main Results:
- HSV hepatitis occurred a median of 18 days post-transplant, with an 67% mortality rate.
- Risk factors for mortality included hypotension, disseminated intravascular coagulation (DIC), metabolic acidosis, and specific laboratory abnormalities.
- Focal liver pathology showed better survival with antiviral therapy compared to diffuse pathology.
Conclusions:
- Early diagnosis and prompt antiviral treatment are crucial for improving survival in HSV hepatitis post-transplantation.
- Acyclovir prophylaxis may be a potential strategy to prevent HSV hepatitis in this vulnerable patient population.