Document Detail


Detection and diagnosis of herpes simplex virus infection in adults with acute liver failure.
MedLine Citation:
PMID:  18825709     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Disseminated herpes simplex virus (HSV) infection may lead to acute liver failure (ALF) and the need for emergency liver transplantation (LT). The primary aim of this study was to determine the utility of HSV serological testing and HSV DNA testing by polymerase chain reaction (PCR) in the diagnosis and management of indeterminate, pregnancy-related, and known HSV-related ALF. Stored sera obtained on study day 1 or 2 from patients enrolled in the United States ALF Study Group with indeterminate (n = 51), pregnancy-related (n = 12), and HSV-related (n = 4) ALF were screened for HSV DNA by PCR and serology. While 7 of the indeterminate and pregnant patients had positive anti-HSV immunoglobulin M, none had detectable HSV DNA. The 4 known HSV cases all had high-titer HSV DNA on presentation (range: 3.5 to 36 x 10(8) copies/mL). Two HSV patients underwent LT but developed posttransplant extrahepatic HSV infection despite suppression of HSV DNA with acyclovir treatment, and one of them eventually died. The 2 other fulminant HSV patients died within 48 hours of presentation. In conclusion, serum HSV DNA indicative of occult HSV infection was not detected in 51 indeterminate and 12 pregnancy-related ALF patients. The 4 patients with known HSV-related ALF all had high HSV DNA levels at presentation, and despite the rapid use of antiviral therapy and emergency LT, substantial morbidity and mortality were encountered, highlighting the poor prognosis with severe disseminated HSV infection.
Authors:
Josh Levitsky; Anupama T Duddempudi; Fred D Lakeman; Richard J Whitley; James P Luby; William M Lee; Robert J Fontana; Andres T Blei; Michael G Ison;
Related Documents :
22859899 - Effects of antiretroviral therapy on autonomic function in early hiv infection: a preli...
22918449 - Current status of topical antiretroviral chemoprophylaxis.
22331649 - Hcv rna levels in a multiethnic cohort of injection drug users: human genetic, viral an...
22536559 - Frequency of human immunodeficiency virus infection among students of tertiary and seco...
22700829 - Etiology and pharmacologic management of noninfectious diarrhea in hiv-infected individ...
22833059 - Cytomegalovirus, aging, and hiv: a perfect storm.
6521429 - A pathological study in cynomolgus monkeys infected with edesonfilaria malayensis.
19915889 - Cardiac isoform of alpha 2 macroglobulin: a marker of cardiac involvement in pediatric ...
8813039 - The relation of virologic and immunologic markers to clinical outcomes after nucleoside...
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society     Volume:  14     ISSN:  1527-6473     ISO Abbreviation:  Liver Transpl.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-06     Completed Date:  2009-01-27     Revised Date:  2013-06-05    
Medline Journal Info:
Nlm Unique ID:  100909185     Medline TA:  Liver Transpl     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1498-504     Citation Subset:  IM    
Copyright Information:
(c) 2008 AASLD.
Affiliation:
Northwestern Memorial Hospital/Northwestern University Feinberg School of Medicine, Chicago, IL, USA. j-levitsky@northwestern.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
DNA, Viral / blood*
Female
Herpes Simplex / blood,  complications,  diagnosis*
Humans
Liver Failure, Acute / virology*
Male
Middle Aged
Polymerase Chain Reaction
Pregnancy
Pregnancy Complications, Infectious / blood,  diagnosis*,  virology
Simplexvirus / isolation & purification*
Young Adult
Grant Support
ID/Acronym/Agency:
U-01 DK58369/DK/NIDDK NIH HHS; U01 DK058369/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
0/DNA, Viral
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Long-term histological effects of preemptive antiviral therapy in liver transplant recipients with h...
Next Document:  Early posttransplant hepatic venous outflow obstruction: Long-term efficacy of primary stent placeme...