Human herpesvirus-6 and -7 after lung and heart-lung transplantation

J Heart Lung Transplant. 2007 Jan;26(1):41-7. doi: 10.1016/j.healun.2006.10.017.

Abstract

Background: The impact of herpesvirus-6 and -7 (HHV-6, HHV-7) activation in lung transplant recipients is still poorly understood. We report the appearance of HHV-6 and HHV-7 antigenemia after lung transplantation and evaluate the efficacy of anti-viral drugs against these viruses.

Methods: Twenty-two lung or heart-lung recipients were monitored for HHV-6, HHV-7 and cytomegalovirus (CMV) during 12 post-operative months. HHV-6- and HHV-7-specific antigens and CMV pp65 antigens were analyzed in blood leukocytes and bronchoalveolar lavage fluid cells by monoclonal antibodies. Ganciclovir or valganciclovir prophylaxis for a minimum of 3 months was given to 19 recipients at risk for CMV infection.

Results: HHV-6, HHV-7 and CMV antigenemia was detected in 20 (91%), 11 (50%) and 12 (55%) recipients (median 16, 31 and 165 days) after transplantation, respectively. HHV-6 antigenemia occurred in 15 (79%), HHV-7 antigenemia in 7 (37%) and CMV antigenemia in 1 (7%) of these patients during anti-viral prophylaxis. HHV-6 or HHV-7 antigenemia was frequently associated with CMV antigenemia, which was detected 3 to 12 months after transplantation. Ganciclovir or valganciclovir treatment of CMV infection was effective against the concomitant HHV-6 and HHV-7 antigenemia in 9 of 12 (75%) and 5 of 6 (83%) cases, respectively. One case of pneumonitis and 1 of encephalitis were temporally associated with HHV-6. No other clinical manifestations could be linked solely to HHV-6 or -7.

Conclusions: HHV-6 and -7 antigenemia was common and appeared early after lung transplantation. CMV prophylaxis was not able to prevent the appearance of HHV-6 and -7 antigenemia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antigens, Viral / immunology*
  • Antiviral Agents / therapeutic use
  • Bronchoalveolar Lavage Fluid / virology
  • Female
  • Follow-Up Studies
  • Heart Transplantation*
  • Herpesvirus 6, Human / immunology*
  • Herpesvirus 7, Human / immunology*
  • Humans
  • Lung Transplantation*
  • Male
  • Middle Aged
  • Postoperative Complications
  • Prognosis
  • Prospective Studies
  • Roseolovirus Infections / epidemiology
  • Roseolovirus Infections / prevention & control
  • Roseolovirus Infections / virology*

Substances

  • Antigens, Viral
  • Antiviral Agents