Human herpesvirus-6 DNAemia is a sign of impending primary CMV infection in CMV sero-discordant renal transplantations

Abstract Background Human herpesvirus-6 (HHV-6) frequently reactivates in immunocompromized individuals. Most commonly HHV-6 DNA is detected without organ localized disease. This HHV-6 DNAemia usually occurs in patients who also have CMV reactivations. The question if reactivation of one virus cause...

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Published in:	Journal of clinical virology Vol. 58; no. 2; pp. 422 - 426
Main Authors:	Van Leer-Buter, C.C, Sanders, J.S.F, Vroom, H.E.J, Riezebos-Brilman, A, Niesters, H.G.M
Format:	Journal Article
Language:	English
Published:	Netherlands Elsevier B.V 01-10-2013
Subjects:	Adult Aged Allergy and Immunology CMV Cytomegalovirus Infections - epidemiology DNA, Viral - blood Female Herpesvirus 6, Human - isolation & purification Human herpesvirus-6 Humans Immunocompromised Host Infectious Disease Kidney Transplantation Male Middle Aged Prognosis Real-Time Polymerase Chain Reaction Renal transplantation Roseolovirus Infections - virology Viral Load Viremia - virology Virus Activation Young Adult Renal transplantation Human herpesvirus-6 CMV
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Summary:	Abstract Background Human herpesvirus-6 (HHV-6) frequently reactivates in immunocompromized individuals. Most commonly HHV-6 DNA is detected without organ localized disease. This HHV-6 DNAemia usually occurs in patients who also have CMV reactivations. The question if reactivation of one virus causes reactivation of the other, or whether both viruses reactivate independently, cannot be answered in populations with high seroprevalence for both viruses. Our study is the first in which 35 patients have been included who were CMV seronegative prior to transplantation. Objective We investigated the occurrence of HHV-6 reactivations in relation to the CMV-serostatus of renal transplantation donor and recipient. Study design 9 consecutive patients receiving a renal transplantation were included. All available stored whole blood samples were tested for HHV-6 DNA by quantitative PCR. Details including CMV serostatus of donor and recipient were recorded. Results CMV-seropositive recipients have a 68% chance of developing HHV-6 DNAemia if the kidney came from a CMV-seropositive donor, compared to 26% if the kidney came from a CMV-seronegative donor. CMV-seronegative recipients, who are bound to undergo primary CMV infections following transplantation with a renal graft from a CMV-seropositive donor, have 88% chance of developing HHV-6 DNAemia. If they receive a graft from a CMV-seronegative donor the chance of developing HHV-6 DNAemia is 22%. Conclusion Receiving a renal transplant from a CMV-seropositive donor increases the chance of developing HHV-6 DNAemia. HHV-6 DNAemia is a sign of impending primary CMV infections following sero-discordant renal transplantations.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1386-6532 1873-5967
DOI:	10.1016/j.jcv.2013.07.014