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[Human herpesvirus-6 infection and hepatitis following heart transplantation]
C Robert1, H Agut, F Lunel-Fabiani
1Laboratoire de Bactériologie-Virologie, CNRS EP 57, CERVI, Groupe hospitalier Pitié-Salpêtrière, Paris.
Insights
Human Herpesvirus-6 (HHV-6) is common after heart transplants but does not cause hepatitis. Further research is needed to understand HHV-6 infection mechanisms and outcomes in transplant patients.
Area of Science:
- Virology
- Immunology
- Transplantation Medicine
Context:
- Human Herpesvirus-6 (HHV-6) is a known cause of hepatitis and has been observed in heart transplant recipients.
- Post-transplantation complications, including hepatitis, are a significant concern in organ recipients.
Purpose:
- To investigate the prevalence of HHV-6 infections in heart transplant patients.
- To determine if HHV-6 infections are associated with post-transplantation hepatitis.
Summary:
- HHV-6 seroprevalence did not significantly differ between heart transplant patients with and without hepatitis, or the general population.
- Evidence of active HHV-6 infection (seroconversion or increased antibody titers) was found in both hepatitis patients and controls.
- HHV-6-specific IgM antibodies were detected in some patients, unlike cytomegalovirus (CMV)-specific IgM.
Impact:
- HHV-6 infection is frequent post-heart transplantation but appears unrelated to hepatitis development.
- The exact mechanism of HHV-6 infection (primary infection vs. reactivation) requires further elucidation.
- The clinical significance of HHV-6 infection in heart transplant recipients, whether asymptomatic or pathogenic, remains to be determined.
Objectives:
Human Herpesvirus-6 (HHV-6) has been implicated in hepatitis and HHV-6 infections have been reported in patients receiving heart transplants. We investigated the occurrence of such infections and their possible relation with post-transplantation hepatitis in 58 heart transplanted patients.
Methods:
The titre of HHV-6 antibodies was determined by anticomplement immunofluorescence assay and compared with the titre of CMV antibodies determined by using ELISA.
Results:
HHV-6 seroprevalence after transplantation did not differ significantly between hepatitis, control patients (without hepatitis) and the healthy general population. In three controls and five hepatitis patients we observed, after transplantation, a seroconversion or a significant increase of antibody titre which suggested active HHV-6 infection. In six cases, HHV-6-specific IgM were found whereas CMV-specific IgM were not detected.
Conclusion:
These results indicate that HHV-6 infection is frequent after heart transplantation but not in relation with hepatitis. The mechanism of this infection needs to be clarified (either primo-infection or reactivation) and the question remains whether this infection is totally asymptomatic or could induce serious illness.