Human Herpesvirus 6 in Bronchalveolar Lavage Fluid after Lung Transplantation: A Risk Factor for Bronchiolitis Obliterans Syndrome?

• Published in: American journal of transplantation Vol. 5; no. 12; pp. 2982 - 2991
• Main Authors: Neurohr, Claus, Huppmann, Patrick, Leuchte, Hanno, Schwaiblmair, Martin, Bittmann, Iris, Jaeger, Gundula, Hatz, Rudolf, Frey, Lorenz, Überfuhr, Peter, Reichart, Bruno, Behr, Jürgen
• Format: Journal Article
• Language: English
• Published: Oxford UK Munksgaard International Publishers 01.12.2005; Blackwell
• Subjects: Adenoviridae Infections - mortality; Adenovirus; Adult; Biological and medical sciences; Bronchalveolar lavage; bronchiolitis obliterans; Bronchiolitis Obliterans - mortality; Bronchiolitis Obliterans - virology; Bronchoalveolar Lavage Fluid - virology; Chronic obstructive pulmonary disease, asthma; Cohort Studies; Cytomegalovirus Infections - mortality; DNA, Viral - analysis; Epstein-Barr virus; Epstein-Barr Virus Infections - mortality; Female; Herpes Simplex - mortality; Herpes simplex virus; Herpesvirus 1, Human; Herpesvirus 2, Human; Herpesvirus 6, Human - genetics; Human cytomegalovirus; Human herpesvirus; Human herpesvirus 6; Humans; Incidence; lung transplantation; Lung Transplantation - mortality; Male; Medical sciences; Middle Aged; Pneumology; Polymerase Chain Reaction; Postoperative Complications - mortality; Postoperative Complications - virology; Risk Factors; Roseolovirus Infections - mortality; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; virus infection; Respiratory disease; Lung; Fluid; Transplantation; Homotransplantation; Respiratory system; Epidemiology; Syndrome; Bronchalveolar lavage; virus infection; Infection; Treatment; Surgery; Viral disease; Risk factor; Bronchus disease; Graft; Bronchiolitis obliterans; lung transplantation; Human herpesvirus 6
• ISSN: 1600-6135; 1600-6143
• DOI: 10.1111/j.1600-6143.2005.01103.x

Bronchiolitis obliterans syndrome (BOS) is the limiting factor to long‐term survival after lung transplantation. Previous studies suggested respiratory viral tract infections are associated with the development of BOS. To identify the impact of virus detection in bronchoalveolar lavage (BAL) fluid, we analyzed BAL samples from 87 consecutive lung transplant recipients for human herpesvirus (HHV)‐6, Epstein‐Barr virus, Herpes simplex virus 1/2, Cytomegalovirus, respiratory syncytical virus and adenovirus by PCR. Acute rejection, BOS and death were recorded for a mean follow‐up time of 3.27 ± 0.47 years. Results of PCR analysis and other potential risk factors were entered into a Cox regression analysis of BOS predictors and death. Only acute rejection was a distinct risk factor for BOS of all stages, death and death from BOS. HHV‐6 was detected in 20 patients. Univariate and multivariate analysis revealed that HHV‐6 was associated with an increased risk to develop BOS ≥ stage 1 and death, separate from the risk attributable to acute rejection. Identification of HHV‐6 DNA in BAL fluid is a potential risk factor for BOS. Our results warrant further studies to elucidate a possible causal link between HHV‐6 and BOS.