TY - JOUR
T1 - Clinical course of human herpesvirus 6 infection in pediatric living donor liver transplantation
AU - Yasui, Toshihiro
AU - Suzuki, Tatsuya
AU - Yoshikawa, Tetsushi
AU - Yatsuya, Hiroshi
AU - Kawamura, Yoshiki
AU - Miura, Hiroki
AU - Hara, Fujio
AU - Watanabe, Shunsuke
AU - Uga, Naoko
AU - Naoe, Atsuki
N1 - Publisher Copyright:
© 2018 The Authors. Pediatric Transplantation Published by Wiley Periodicals, Inc
PY - 2018/11
Y1 - 2018/11
N2 - Differentiation between active and latent viral infection is critical for analysis of HHV-6-associated disease. HHV-6 infection has been associated with several clinical manifestations; however, the precise role of HHV-6 in pediatric LDLT remains unclear. This retrospective cohort study included 33 pediatric patients who received LDLT. All of the recipients were monitored for HHV-6 infection using viral isolation and real-time PCR. HHV-6 infection was observed in 14 of 33 (42.4%) recipients, and HHV-6B infection occurred within 2 weeks after LDLT in 10 of 14 (71.4%) recipients. HHV-6 was isolated from 10 of 33 (30.3%) recipients. Multivariate analysis showed that independent predictors of HHV-6B infection were age (OR 0.975; 95% CI 0.943-0.999; P =.041), PELD (OR 1.091; P =.038), and biliary atresia (OR 16.48; P =.035). The occurrence of unexplained fever was significantly higher in recipients with HHV-6B infection (11/14) compared with uninfected recipients (6/19) (P =.013). Additionally, ALT levels at 8 and 9 weeks after transplantation were significantly higher in the recipients with HHV-6B infection. Younger age, high MELD/PELD score, and biliary atresia as an underlying disease were identified as risk factors for viral infection.
AB - Differentiation between active and latent viral infection is critical for analysis of HHV-6-associated disease. HHV-6 infection has been associated with several clinical manifestations; however, the precise role of HHV-6 in pediatric LDLT remains unclear. This retrospective cohort study included 33 pediatric patients who received LDLT. All of the recipients were monitored for HHV-6 infection using viral isolation and real-time PCR. HHV-6 infection was observed in 14 of 33 (42.4%) recipients, and HHV-6B infection occurred within 2 weeks after LDLT in 10 of 14 (71.4%) recipients. HHV-6 was isolated from 10 of 33 (30.3%) recipients. Multivariate analysis showed that independent predictors of HHV-6B infection were age (OR 0.975; 95% CI 0.943-0.999; P =.041), PELD (OR 1.091; P =.038), and biliary atresia (OR 16.48; P =.035). The occurrence of unexplained fever was significantly higher in recipients with HHV-6B infection (11/14) compared with uninfected recipients (6/19) (P =.013). Additionally, ALT levels at 8 and 9 weeks after transplantation were significantly higher in the recipients with HHV-6B infection. Younger age, high MELD/PELD score, and biliary atresia as an underlying disease were identified as risk factors for viral infection.
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U2 - 10.1111/petr.13239
DO - 10.1111/petr.13239
M3 - Article
C2 - 29862613
AN - SCOPUS:85055180308
SN - 1397-3142
VL - 22
JO - Pediatric Transplantation
JF - Pediatric Transplantation
IS - 7
M1 - e13239
ER -