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Early HHV-6 replication is associated with morbidity non-related to CMV infection after kidney transplantation.
Schroeder, Regina Barbosa; Michelon, Tatiana Ferreira; Garbin, Gabriela; Garcia, Valter; Silveira, Janaina Gomes da; Santos, Luciano; Neumann, Jorge; Keitel, Elizete.
Afiliação
  • Schroeder RB; Complexo Hospitalar Santa Casa de Misericórdia de Porto Alegre, Universidade Federal de Ciências Médicas de Porto Alegre, Porto Alegre, RS, Brazil. rbs_schroeder@hotmail.com
Braz J Infect Dis ; 16(2): 146-52, 2012.
Article em En | MEDLINE | ID: mdl-22552456
UNLABELLED: Human herpesvirus type 6-(HHV-6) has been associated with morbidity after liver transplantation. OBJECTIVE: The aim of this study was to determine the HHV-6 seroprevalence among donor-recipient pairs, analyze the incidence of early active infection, its clinical manifestation, interaction with CMV, and the related morbidity in the first year after kidney transplantation. METHODS: 46 donor-recipient pairs had IgG evaluated by ELISA before transplantation: HHV-6(Pambio - USA) and CMV-(Roche - USA). A frozen whole blood sample collected weekly (from the 1st to the 6th week) was retrospectively tested for HHV-6 viral load (VL) determination by real time quantitative PCR (qPCR, Nanogen - Italy). Patients were preemptively surveyed for CMV by pp65 antigenemia (Ag, APAAP, immunohistochemistry, Biotest - Germany) from the 4th to the 12th week after transplantation. Active infection was defined as qPCR-HHV6+ (viral-load/mL-VL) and Ag+ (+cells/100.000 granulocytes), for HHV-6 and CMV, respectively. DCMV was defined as simultaneous positive antigenemia and suggestive signs/symptoms. Concerning +qPCR-HHV6, associated factors, clinical manifestation, interaction with CMV and morbidity were searched. RESULTS: Pre-transplant HHV-6 seroprevalence was significantly higher among kidney recipients compared to their donors (82.6x54.8%; p = 0.005 [3.9 (1.4-10.4)]). Active infection by this virus occurred in 26.1% (12/46), with no association with previous IgG (p = 0.412). Median VL was 125 copies/mL (53-11.264), and the median Ag was 21 +cells (2-740). There was no association between HHV-6 and CMV activation after transplantation (p = 0.441), neither concerning DCMV (p = 0.596). Median highest Ag+ and days of ganciclovir treatment were similar between qPCR-HHV6 + or - (p = 0.206 and p = 0.124, respectively). qPCR-HHV6+ was associated with higher incidence of bacterial (p = 0.009) and fungal (p = 0.001) infections, and higher number (p = 0.001) of hospital admission and longer duration of hospitalization over the first 6 and 12 months post-transplantation (p = 0.033 and p = 0.001). CONCLUSION: Latent HHV-6 infection is more common among recipients than donors before transplantation. Early active infection by this pathogen after transplantation does not increase DCMV incidence or severity during the first 3 months of follow-up. However, early HHV-6 replication is associated with other infections and hospitalizations in the first year.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Replicação Viral / Transplante de Rim / Herpesvirus Humano 6 / Infecções por Citomegalovirus / Infecções por Roseolovirus Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male Idioma: En Revista: Braz J Infect Dis Assunto da revista: DOENCAS TRANSMISSIVEIS Ano de publicação: 2012 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Replicação Viral / Transplante de Rim / Herpesvirus Humano 6 / Infecções por Citomegalovirus / Infecções por Roseolovirus Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male Idioma: En Revista: Braz J Infect Dis Assunto da revista: DOENCAS TRANSMISSIVEIS Ano de publicação: 2012 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil