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There have been extensive studies carried with respect to the role of HHV-6 in transplantation over the past few years. Persons at risk are recipients of bone marrow, kidney and liver transplants in whom immunosuppression is induced for therapeutic reasons. Monitoring of HHV-6 has not yet become routine practice, however with the increasing number of transplants and subsequent infections, this may soon be required. - HHV-6 has been associated with fever and skin rash in renal transplant recipients and fever, skin rash, graft versus host disease (GVHD), pneumonia and suppression of engraftment in bone marrow transplant recipient's(1).
- In studies of bone marrow transplant recipients it was found that HHV-6 activity was more frequent during the post- rather than the pre-transplantation period. All HHV-6 isolates were variant B.
- It has been suggested that HHV-6 may cause disease in transplant patients through direction interaction or through a general immunomodulatory effect(2).
- One recent study(4) showed that CMV occurrence was nearly twice as high in patients who were HHV-6 positive supporting an interaction between these viruses.
- In other studies, HHV-6 has been isolated from bone marrow and blood, strongly implementing HHV-6 as a cause of bone marrow suppression and CNS disease in both BMT and liver transplant patients(5).
- In a study of liver transplant recipients, HHV-6 reactivation accounted for 80% of the cases of idiopathic leukopenia and were the predominant cause of febrile illness(5). This data, together with other studies, suggests that the incidence of HHV-6 infection after liver transplant is approximately 50%.
Diagnosis of HHV-6 in transplant recipients is clinically relevant because HHV-6 is susceptible to the currently available antiviral agents and is therefore potentially treatable.
References: - Human Herpesvirus 6:An Emerging Pathogen.May-June 1999. Vol 5 No 3
- Human herpesvirus 6 infection and associated pathogenesis following bone marrow transplantation. Kadakia MP. Leuk lymphoma 1998 Oct;31 (3-4): 251-66.
- Clark et al Rev Med Virol 2000 May;10(3): 155-173
- Humar et al. Human herpesvirus-6 is associated with cytomegalovirus reactivation in liver transplant recipients.
- Gautheret-Dejean et al. Transplantation 2000, Apr27,69(8):1722-3
Links of Interest Transplant Information:
http://www.transweb.org Nephrology, Dialysis, Transplantation Journal Website:
http://oxfordjournals.org American Society for Transplantation:
http://www.a-s-t.org/ The Transplantation Society:
http://www.transplantation-soc.org/ The National Institute for Transplantation:
http://www.transplantation.com/ American Liver Foundation:
http://www.liverfoundation.org/ Organ Donor - A Government Information Portal:
http://www.organdonor.gov/
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