Herpes simplex type 1 hepatitis in renal transplantation

Area of Science:

• Hepatology
• Virology
• Transplantation Immunology

Background:

• Herpes simplex virus (HSV) is a rare but often fatal cause of acute hepatitis in adults.
• Previous cases predominantly affected debilitated or immunosuppressed patients.
• Renal transplant recipients represent a vulnerable population due to immunosuppression.

Observation:

• Two fatal cases of HSV hepatitis in renal transplant recipients are presented.
• In one case, the kidney allograft may have been the primary site of HSV infection.
• In the second case, disseminated HSV infection originated from a genital source.

Findings:

• HSV hepatitis can be rapidly fatal in immunosuppressed transplant patients.
• Early vidarabine therapy was ineffective in one of the reported cases.
• The review of literature confirms the high mortality associated with HSV hepatitis.

Implications:

• Reinforces the need for vigilance regarding HSV infections in renal transplant recipients.
• Suggests potential challenges in treating HSV hepatitis, even with early antiviral intervention.
• Highlights the critical role of the immune system in controlling HSV reactivation and preventing hepatitis.