• Journal of hepatology · May 2012

    Comparative Study

    High intrahepatic HHV-6 virus loads but neither CMV nor EBV are associated with decreased graft survival after diagnosis of graft hepatitis.

    • Sven Pischke, Juliane Gösling, Ilka Engelmann, Jerome Schlue, Benno Wölk, Elmar Jäckel, Christoph Meyer-Heithuis, Ulrich Lehmann, Christian P Strassburg, Hannelore Barg-Hock, Thomas Becker, Michael P Manns, Thomas Schulz, Heiner Wedemeyer, and Albert Heim.
    • Department for Gastroenterology, Hannover Medical School, Hannover, Germany.
    • J. Hepatol. 2012 May 1;56(5):1063-9.

    Background & AimsIn liver transplant recipients with graft hepatitis, the relevance of herpesviruses is not well defined.MethodsViral loads of CMV, EBV, and HHV-6 were determined in blood and liver biopsies of 170 liver transplant recipients with graft hepatitis by quantitative PCR.ResultsHHV-6-, CMV-, and EBV-DNA were detected in 58%, 14%, and 44% of the biopsies, respectively, with coinfections in 34%. High intrahepatic HHV-6 DNA levels (>75th percentile, 11.27 copies/1000 cells) and detection of HHV-6 DNAemia were significantly associated with decreased graft survival after diagnosis of graft hepatitis (p=0.014 and p=0.003, respectively, median follow-up was 23.8 months). Multivariate analysis confirmed high intrahepatic HHV-6 loads as an independent factor associated with reduced graft survival (adjusted hazard ratio 2.61, 95%confidence interval 1.16-5.87). Low concentrations of HHV6 DNA in the liver, indicating latent infection, did not influence graft survival. Neither CMV nor EBV (qualitative detection and high virus loads) nor acute rejection (according to the BANFF score) affected graft survival. However, patients had been treated for CMV reactivations and acute rejections in this retrospective study. High age and high bilirubin levels were the other independent factors associated with reduced graft survival (adjusted hazard ratio 3.56CI 1.52-8.34 and 3.23CI 1.50-6.96, respectively).ConclusionsHigh intrahepatic HHV-6-DNA levels are associated with decreased graft survival in liver transplant recipients with graft hepatitis. The significance of HHV-6 as potential etiology of graft hepatitis needs further evaluation.Copyright © 2012 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

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