Association of HHV-6 and HHV-7 reactivation with the development of chronic allograft nephropathy |
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Authors: | S. Chapenko I. Folkmane I. Ziedina M. Chistyakovs R. Rozentals A. Krumina M. Murovska |
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Affiliation: | aAugust Kirchenstein Institute of Microbiology and Virology, Riga Stradins University, Ratsupites St. 5, LV-1067 Riga, Latvia;bThe Transplantology Laboratory, Riga Stradins University, Riga, Latvia |
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Abstract: | BackgroundThe long-term effect of HHV-6 and HHV-7 infections on chronic allograft nephropathy (CAN) development after renal transplantation is uncertain.ObjectivesTo determine HHV-6 and HHV-7 reactivation during the post-transplantation period and to evaluate its effect on CAN development in renal transplant patients.Study designEighty-one renal allograft recipients (28 with CAN, 53 with normal transplant function) were studied to determine the frequency of HHV-6 and HHV-7 reactivation during 36.4 ± 7.8 months after renal transplantation using nested PCR. HHV-6 variants were identified using restriction endonuclease analysis. Patients were monitored for the development of CAN.ResultsThe frequency of HHV-6 and/or HHV-7 plasma DNA was significantly higher in CAN patients (25/28, 89.3%) compared to control patients (15/50, 30.0%, p = 0.0001). CAN patients also had an increased incidence of dual active infections (20/25, 80% and 2/15, 13.3%, p = 0.007, respectively). In all 34 HHV-6 positive cases, the HHV-6B variant was identified. The presence of HHV-7 DNA in plasma preceded the presence of HHV-6 DNA. Early development of CAN and graft loss was detected only in patients with simultaneous HHV-6 and HHV-7 plasma DNA.ConclusionsReactivation of HHV-6 and HHV-7 in renal graft recipients is a risk factor for CAN development. The presence of concurrent HHV-6 and HHV-7 DNA in the plasma is an unfavorable prognostic factor. |
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Keywords: | Renal transplantation Chronic allograft nephropathy Human herpesvirus-6 Human herpesvirus-7 Virus activation Acute rejection |
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