Impact of human herpes virus 6 in liver transplantation  

作　　者：Raymund R Razonable Irmeli Lautenschlager 

机构地区：[1]Division of Infectious Diseases,Department of Medicine,and the William J von Liebig Transplant Center,College of Medicine,Mayo Clinic,Rochester [2]Transplant Unit Research Laboratory,Transplantation and Liver Surgery Clinic,and Department of Virology,Helsinki University Hospital [3]University of Helsinki

出　　处：《World Journal of Hepatology》2010年第9期345-353,共9页世界肝病学杂志（英文版）（电子版）

摘　　要：Human herpes virus 6 (HHV-6) infects > 95% of humans.Primary infection which occurs mostly during the f irst 2 years of life in the form of roseola infantum,non-spe cif ic febrile illness,or an asymptomatic illness,results in latency.Reactivation of latent HHV-6 is common after liver transplantation.Since the majority of human beings harbor the latent virus,HHV-6 infections after liver transplantation are most probably caused by end ogenous reactivation or superinfection.In a minority of cases,primary HHV-6 infection may occur when an HHV-6-seronegative individual receives a liver allograft from an HHV-6-seropositive donor.The vast major ity of HHV-6 infections after liver transplantation are asy-mptomatic.Only in a minority of cases,when HHV-6 causes a febrile illness associated with rash and mye- losuppression,hepatitis,gastroenteritis,pneumonitis,and encephalitis after liver transplantation.In addition,HHV-6 has been implicated in a variety of indirect effects,such as allograft rejection and increased predis- pos ition to and severity of other infections,includingcytomegalovirus,hepatitis C virus,and opportunistic fungi.Because of the uncommon nature of the clinical illnesses directly attributed to HHV-6,there is currently no recommended HHV-6-specific approach prevention after liver transplantation.Asymptomatic HHV-6 infection does not require antiviral treatment,while treatment of established HHV-6 disease is treated with intravenous ganciclovir,foscarnet,or cidofovir and this should be com plemented by a reduction in immunosuppression.Human herpes virus 6 (HHV-6) infects > 95% of humans.Primary infection which occurs mostly during the f irst 2 years of life in the form of roseola infantum,non-spe cif ic febrile illness,or an asymptomatic illness,results in latency.Reactivation of latent HHV-6 is common after liver transplantation.Since the majority of human beings harbor the latent virus,HHV-6 infections after liver transplantation are most probably caused by end ogenous reactivation or superinfection.In a minority of cases,primary HHV-6 infection may occur when an HHV-6-seronegative individual receives a liver allograft from an HHV-6-seropositive donor.The vast major ity of HHV-6 infections after liver transplantation are asy-mptomatic.Only in a minority of cases,when HHV-6 causes a febrile illness associated with rash and mye- losuppression,hepatitis,gastroenteritis,pneumonitis,and encephalitis after liver transplantation.In addition,HHV-6 has been implicated in a variety of indirect effects,such as allograft rejection and increased predis- pos ition to and severity of other infections,includingcytomegalovirus,hepatitis C virus,and opportunistic fungi.Because of the uncommon nature of the clinical illnesses directly attributed to HHV-6,there is currently no recommended HHV-6-specific approach prevention after liver transplantation.Asymptomatic HHV-6 infection does not require antiviral treatment,while treatment of established HHV-6 disease is treated with intravenous ganciclovir,foscarnet,or cidofovir and this should be com plemented by a reduction in immunosuppression.

关 键 词：Human HERPES VIRUS 6 OPPORTUNISTIC INFECTIONS Liver TRANSPLANTATION ANTIVIRALS 

分 类 号：R363[医药卫生—病理学]