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Detection of simultaneous β-herpesvirus infections in clinical syndromes due to defined cytomegalovirus infection

Authors


  • Hester van Cruijsen was a visiting medical student from the University of Groningen, the Netherlands, and was supported by the Foundation of Jan Kornelis de Cock Stichling during the conduct of this study.

    Presented in part at the 39th annual meeting of the Infectious Diseases Society of America (2001), San Francisco, CA (abstract 444).

Corresponding author: Dr Carlos V Paya, Division of Infectious Diseases, Mayo Clinic, 200 First Street SW, GU 501, Rochester, MN 55905, USA. Tel.: 507 284 3747, fax: 507 284 3757, e-mail: paya@mayo.edu

Abstract

Abstract: Human herpesvirus (HHV)-6 and HHV-7 are increasingly being recognized as emerging pathogens among transplant recipients. Using quantitative polymerase chain reaction assays, we demonstrate the presence of HHV-6 and/or HHV-7 in 18 of 20 episodes of clinically presumed or microbiologically confirmed cytomegalovirus (CMV) infection. Seventeen (89%) of 19 microbiologically confirmed cytomegalovirus (CMV)-infected patients had concomitant HHV-6 variant B (47%) and/or HHV-7 (63%) infection. The degree of HHV-6 coinfection was significantly correlated with hyperbilirubinemia while HHV-7 coinfection demonstrated a non-significant trend toward cytopenias. In one of the 20 episodes described herein, the ‘viral syndrome’ was due solely to HHV-7 infection; clinical and virological response was observed during intravenous ganciclovir therapy in this patient. While this study emphasizes the significance of HHV-6 and/or HHV-7 coinfection during episodes of CMV infection, it significantly highlights the novel observation of the causal role of HHV-7 (in the absence of HHV-6 and CMV) in a clinical illness presumed to be caused CMV. Thus, HHV-7 (and HHV-6) should be considered as a pathogen (or copathogen) in the viral syndromes following organ transplantation.

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