Transplantation Reports (Sep 2020)

Management of alpha-herpesvirus infection following kidney transplantation: Our experience (7 cases)

  • Hirofumi Uehara,
  • Hajime Hirano,
  • Tomohisa Matsunaga,
  • Koichiro Minami,
  • Kazumasa Komura,
  • Naokazu Ibuki,
  • Teruo Inamoto,
  • Hayahito Nomi,
  • Haruhito Azuma

Journal volume & issue
Vol. 5, no. 3
p. 100051

Abstract

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Background: Kidney transplantation is the definitive treatment for patients with end-stage kidney diseases. Quality of life and longevity following transplantation are nearly equal to those of healthy individuals. Immunosuppression has improved graft survival but leaves the patient susceptible to viral infections. Alpha-herpesviruses belong to a subfamily of herpesviruses and are widely distributed in nature. The human alpha-herpesviruses include herpes simplex virus types 1 and 2 (HSV-1 and HSV-2) and varicella zoster virus (VZV). HSV-1, HSV-2 and VZV often reactivate in the setting of immune suppression after kidney transplantation. The management of infectious disease in transplantation are major contributors to improved outcomes in organ transplantation. Objectives: The aim of this study was to report cases of alpha-herpesvirus infection following kidney transplantation. Methods: From July 2014 to December 2018, we performed 55 kidney transplantations at Osaka Medical College Hospital. All alpha-herpesvirus infection cases following kidney transplantation were retrospectively evaluated. Results: We treated 7 patients with alpha-herpesvirus infection. Median age was 60; 2 patients were female. All patients were able to be treated with acyclovir and valacyclovir. A patient was complicated by postherpetic neuraglia (chronic pain). A patient was complicated by secondary bacterial infection and treated with antibiotic. Conclusion: The human alpha-herpesviruses include HSV-1, HSV-2 and VZV often reactivate after kidney transplantation. This case report demonstrates the successful medical treatment of alpha-herpesvirus infection cases following kidney transplantation.

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