Primary and reactivated HHV8 infection and disease after liver transplantation: A prospective study

G. Pietrosi, G. Vizzini, L. Pipitone, G. Di Martino, M. I. Minervini, G. Lo Iacono, P. G. Conaldi, P. Grossi, V. Lamonaca, L. Galatioto, S. Gruttadauria, B. Gridelli

Research output: Contribution to journalArticle

Abstract

Human herpesvirus 8 (HHV8) is pathogenic in humans, especially in cases of immunosuppression. We evaluated the risk of HHV8 transmission from liver donors, and its clinical impact in southern Italy, where its seroprevalence in the general population is reported to be as high as 18.3%. We tested 179 liver transplant recipients and their donors for HHV8 antibodies at the time of transplantation, and implemented in all recipients a 12-month posttransplant surveillance program for HHV8 infection. Of the 179 liver transplant recipients enrolled, 10.6% were HHV8 seropositive before transplantation, whereas the organ donor's seroprevalence was 4.4%. Eight seronegative patients received a liver from a seropositive donor, and four of them developed primary HHV8 infection. Two of these patients had lethal nonmalignant illness with systemic involvement and multiorgan failure. Among the 19 HHV8 seropositive recipients, two had viral reactivation after liver transplantation. In addition, an HHV8 seronegative recipient of a seronegative donor developed primary HHV8 infection and multicentric Castleman's disease. In conclusion, primary HHV8 infection transmitted from a seropositive donor to a seronegative liver transplant recipient can cause a severe nonmalignant illness associated with high mortality. Donor screening for HHV8 should be considered in geographic areas with a high prevalence of such infection.

Original languageEnglish
Pages (from-to)2715-2723
Number of pages9
JournalAmerican Journal of Transplantation
Volume11
Issue number12
DOIs
Publication statusPublished - Dec 2011

Keywords

  • donor screening
  • Donor/recipient matching
  • HHV8
  • HHV8 seroprevalence
  • liver transplantation

ASJC Scopus subject areas

  • Transplantation
  • Immunology and Allergy
  • Pharmacology (medical)

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