Human herpesvirus 6 seronegativity before transplantation predicts the occurrence of fungal infection in liver transplant recipients

被引:62
作者
Dockrell, DH
Mendez, JC
Jones, M
Harmsen, WS
Ilstrup, DM
Smith, TF
Wiesner, RH
Krom, RAF
Paya, CV
机构
[1] Mayo Clin & Mayo Fdn, Div Infect Dis, Rochester, MN 55905 USA
[2] Mayo Clin & Mayo Fdn, Div Transplantat Surg, Rochester, MN 55905 USA
关键词
D O I
10.1097/00007890-199902150-00010
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background Invasive fungal infection has a major impact on the morbidity and mortality of liver transplant recipients. Human herpesvirus (HHV)-6 infection after transplantation is associated with an immunosuppressive state and the development of cytomegalovirus disease. Because cytomegalovirus infection is a risk factor for invasive fungal infection after transplantation, we have examined whether HHV-6 and fungal infection are associated after transplantation. Methods. Pretransplantation sera from 247 consecutive liver transplant recipients were analyzed for IgG to HHV-6, Thirty-three (13%) HHV-6-seronegative recipients were identified. Six of 33 (18%) seronegative recipients experienced fungal infection as compared with 15 of 214 (7%) seropositive recipients (P = 0.034), Results, In a univariate analysis of risk factors for fungal infection, pretransplantation seronegativity to HHV-6 (P = 0.034), intraoperative cryoprecipitate requirements greater than the 75th percentile (P = 0.035), reoperation (P = 0.005), biliary stricturing postoperatively (P = 0.046), and gastrointestinal or vascular complications postoperatively (P = 0.030) were identified as significant risk factors. Moreover, in pairwise multivariate analysis, pretransplantation HHV-6 seronegativity remained a significant variable even in the presence of each of the other variables. Conclusions. These results suggest that HHV-6 seronegativity before transplantation is a valuable clinical marker that identifies patients at risk for developing fungal infection after transplantation.
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页码:399 / 403
页数:5
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