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Does CD134 upregulation explain why HHV-6 reactivates preferentially in DRESS/ DIHS?

In All, Drug Hypersensitivity, Latest Scientific News, Skin Conditions, Transplant Complications by Kristin Loomis

It has long been a mystery why HHV-6 is preferentially reactivated in drug reaction with eosinophilia and systemic symptoms (DRESS), also known as drug induced hypersensitivity syndrome (DIHS). HHV-6 reactivation occurs in over 60% of severe cases and is part of the definition of DIHS in Japan. Investigators in Japan suspect that the explanation may lie with the CD134 receptor on activated CD4 cells.

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GAD antibodies & HHV-6 limbic encephalitis – a case of molecular mimicry?

In All, Autoimmune Disease, CNS Disease, CNS Dysfunction, Encephalitis & Encephalopathy, Epilepsy and Seizures, Host Cell Interaction by Kristin Loomis

A fifth case of limbic encephalitis associated with GAD antibodies and HHV-6 infection has been reported, this time in an immunocompetent woman with chromosomally integrated HHV-6, epilepsy, and psychosis. The patient’s condition improved (with a drop in GAD antibody titers and stabilization of psychotic symptoms) in response to three weeks of antiviral therapy but relapsed when antiviral therapy was withdrawn.

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HHV-6 & 7 found in spinal fluid of immunocompetent children suspected of CNS infection

In All, CNS Disease, CNS Dysfunction, Latest Scientific News by Kristin Loomis

An Italian study on immunocompetent children with suspected CNS infections found HHV-6 and HHV-7 DNA in 4.2% and 4.8% of 304 cerebrospinal fluid (CSF) samples, respectively. Although once considered rare in the immunocompetent, recent studies with more sensitive methods have found HHV-6 in the CSF of 4-17% of immunocompetent children with seizures or suspected CNS infections.

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Drug-induced liver injury and HHV-6 reactivation without rash or fever

In All, Liver Disease, Transplant Complications by Kristin Loomis

Another case of drug induced liver injury accompanied by HHV-6 reactivation has been reported in Japan, the second such case without exanthema to be described. An earlier case was reported last year (Fujita 2015). The authors suggest that drug-induced liver injury cases be investigated for HHV-6 reactivation when liver dysfunction begins several weeks after the initiation of a new drug typically associated with hypersensitivity syndromes.

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Mystery: Why was ciHHV-6A integration lost with tumor formation?

In All, Genes & Proteins, Molecular Biology by Kristin Loomis

Another case of drug induced liver injury accompanied by HHV-6 reactivation has been reported in Japan, the second such case without exanthema to be described. An earlier case was reported last year (Fujita 2015). The authors suggest that drug-induced liver injury cases be investigated for HHV-6 reactivation when liver dysfunction begins several weeks after the initiation of a new drug typically associated with hypersensitivity syndromes.

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Virus-specific immunotherapy for transplant patients with primary immune deficiencies

In All, Immunology, Transplant Complications, Treatments - Adoptive T cell by Kristin Loomis

A group from Baylor College of Medicine reviewed the efficacy of treating viral infections in transplant patients with primary immunodeficiencies using their viral-specific T lymphocytes. A total of 36 patients were treated with these immunotherapy infusions before or after undergoing hematopoietic stem cell transplantation, and a complete or partial antiviral response were seen in 86% of patients with CMV, 76% of patients with EBV and all patients with adenovirus or HHV-6.

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Highlights from the 9th International Conference on HHV-6 & 7

In All by Kristin Loomis

A summary of the highlights from the 9th International conference on HHV-6 & 7, held in Boston in November 2015, has been published. This summary may be downloaded free of charge from the Foundation web site at this link, from May 25 through August 1st. Many thanks to Anthony Komaroff, MD and the Conference Co-Chairs Louis Flamand, PhD and Philip Pellett, PhD for preparing this summary and to the editors of the journal for making the summary available free of charge for this period.

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Can depression, psychiatric disorders and fatigue be triggered by a neurovirulent latent HHV-6B protein?

In All, CNS Disease, CNS Dysfunction, Cognitive Dysfunction by Kristin Loomis

Three virologists led by Kazuhiro Kondo, MD, PhD, a professor of virology at Jikei University School of Medicine, have filed a patent on a method to diagnose and treat prevent mood disorders which he says are initiated by latent and neurovirulent HHV-6B residing in glial cells, and that this condition can be treated effectively with nasal sprays, using the olfactory nerve as a route to the brain. Dr. Kondo has named this protein SITH-1 or “small protein encoded by intermediate state transcript”.

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Superinfection of HHV-6A in ciHHV6A patients with recurrent cardiac disease: a full genome analysis

In All, ciHHV-6, Genes & Proteins, Heart Disease, Latest Scientific News by Kristin Loomis

A group led by Ursula Gompels from the London School of Hygiene & Tropical Medicine, University of London, did next generation sequencing on three ciHHV6A cardiac patients and found superinfections of HHV-6A in two of the three. They characterized the first full genome sequence of ciHHV-6A and demonstrated the inherited ciHHV6 genome was similar but distinct from known exogenous (community acquired) strains of HHV-6A .

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Elevated levels of HHV-6 DNA in Alzheimer’s, linked to variants in antiviral genes

In All, Alzheimer's Disease by hhv6foundation

A group from Italy’s University of Bologna report that genetic defects in antimicrobial defense mechanisms can leave some individuals vulnerable to sub-clinical infections that lead to cognitive decline as they age. They found variations in specific antiviral genes that correlate with HHV-6 DNA levels in brain tissue and blood from patients with Alzheimer’s disease.

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GAD antibodies & HHV-6 limbic encephalitis – a case of molecular mimicry?

In All, Autoimmune Disease, CNS Disease, CNS Dysfunction, Encephalitis & Encephalopathy, Epilepsy and Seizures, Host Cell Interaction by Kristin Loomis

A fifth case of limbic encephalitis associated with GAD antibodies and HHV-6 infection has been reported, this time in an immunocompetent woman with chromosomally integrated HHV-6, epilepsy, and psychosis. The patient’s condition improved (with a drop in GAD antibody titers and stabilization of psychotic symptoms) in response to three weeks of antiviral therapy but relapsed when antiviral therapy was withdrawn.

Epstein-Barr Virus and Human herpes virus 6 Type A DNA Enhance IL-17 Production in Mice

In All, Autoimmune Disease, News by hhv6foundation

Since both HHV-6 and EBV have been associated with an increased risk of autoimmune disease development, a group at the American University of Beirut studied whether viral DNA might be capable of triggering IL-17, a cytokine associated with autoimmune disease. They injected BALB/c mice intraperitoneally with either EBV or HHV-6A DNA. They found that both IL-17 and IL-23 were markedly elevated.

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Delirium associated with HHV-6B reactivation in cord blood transplant patients: time for an antiviral prophylaxis trial?

In All, Chronic Fatigue Syndrome, Cognitive Dysfunction, Encephalitis & Encephalopathy, Showcase, Transplant Complications by Kristin Loomis

A prospective study authored by Joshua Hill and Danielle Zerr determined that higher than average HHV-6B DNA levels increased the odds of developing delirium after cord blood transplantation (CBT) by almost three fold. Patients with DNA loads in the top quartile had a 4.5 fold increase in delirium.

See All Chronic Fatigue Syndrome Articles
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Superinfection of HHV-6A in ciHHV6A patients with recurrent cardiac disease: a full genome analysis

In All, ciHHV-6, Genes & Proteins, Heart Disease, Latest Scientific News by Kristin Loomis

A group led by Ursula Gompels from the London School of Hygiene & Tropical Medicine, University of London, did next generation sequencing on three ciHHV6A cardiac patients and found superinfections of HHV-6A in two of the three. They characterized the first full genome sequence of ciHHV-6A and demonstrated the inherited ciHHV6 genome was similar but distinct from known exogenous (community acquired) strains of HHV-6A .

CiHHV-6A is the dominant virus in malignancy and inflammatory disease cases, while ciHHV-6B is the dominant virus in myocarditis cases

In All, ciHHV-6, Heart Disease, News by hhv6foundation

A sequencing study led by Ursula Gompels of London School of Hygiene & Tropical Medicine, found that 95% (19/21) of Czech ciHHV-6 malignancy and inflammatory disease patients had ciHHV6A while 65% (13/20) of a German myocarditis cohort had ciHHV-6B. The authors propose that this divergence suggests different disease links for the two viruses.

Expert Opinion: Dr. Louis Flamand calls for screening of transplant organs and cells for ciHHV-6 status

In All, ciHHV-6, Featured, Transplant Complications by hhv6foundation

Dr. Flamand, a professor and molecular virologist at Université Laval in Quebec city, has written an editorial calling for screening of organ donors for ciHHV-6 status and careful monitoring of recipients of ciHHV-6 donor tissues for signs of active HHV-6 infection and HHV-6 antigen-induced immune rejection. Flamand also questions whether solid organs and stem cells derived from persons with ciHHV-6 should be used in transplantation.

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Can depression, psychiatric disorders and fatigue be triggered by a neurovirulent latent HHV-6B protein?

In All, CNS Disease, CNS Dysfunction, Cognitive Dysfunction by Kristin Loomis

Three virologists led by Kazuhiro Kondo, MD, PhD, a professor of virology at Jikei University School of Medicine, have filed a patent on a method to diagnose and treat prevent mood disorders which he says are initiated by latent and neurovirulent HHV-6B residing in glial cells, and that this condition can be treated effectively with nasal sprays, using the olfactory nerve as a route to the brain. Dr. Kondo has named this protein SITH-1 or “small protein encoded by intermediate state transcript”.

View Post

Delirium associated with HHV-6B reactivation in cord blood transplant patients: time for an antiviral prophylaxis trial?

In All, Chronic Fatigue Syndrome, Cognitive Dysfunction, Encephalitis & Encephalopathy, Showcase, Transplant Complications by Kristin Loomis

A prospective study authored by Joshua Hill and Danielle Zerr determined that higher than average HHV-6B DNA levels increased the odds of developing delirium after cord blood transplantation (CBT) by almost three fold. Patients with DNA loads in the top quartile had a 4.5 fold increase in delirium.

See All Cognitive Dysfunction Articles
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Does CD134 upregulation explain why HHV-6 reactivates preferentially in DRESS/ DIHS?

In All, Drug Hypersensitivity, Latest Scientific News, Skin Conditions, Transplant Complications by Kristin Loomis

It has long been a mystery why HHV-6 is preferentially reactivated in drug reaction with eosinophilia and systemic symptoms (DRESS), also known as drug induced hypersensitivity syndrome (DIHS). HHV-6 reactivation occurs in over 60% of severe cases and is part of the definition of DIHS in Japan. Investigators in Japan suspect that the explanation may lie with the CD134 receptor on activated CD4 cells.

HHV-6 induced kidney damage in drug hypersensitivity

In Drug Hypersensitivity, Kidney Disease by hhv6foundation

A new case study suggests that HHV-6 might play a role in the multi-organ failure that often follows extreme cases of drug hypersensitivity. Although there have been many studies documenting HHV-6 viremia in drug hypersensitivity (DIHS/DRESS) cases, this is the first to examine an affected organ for signs of HHV-6 DNA and proteins. The mortality rate from severe drug hypersensitivity is approximately 10%, and death usually results from a late flare in symptoms and failure of one or more organ, typically the liver, kidney, lungs or heart. HHV-6 viremia occurs in the majority of extreme drug hypersensitivity cases (Pritchett 2012) but the reason for the disproportionate reactivation of HHV-6 is not understood. The case, which is presented by a Japanese …

Pediatric drug hypersensitivity cases with HHV-6 reactivation have a more severe disease and longer hospital stays

In All, Drug Hypersensitivity, News by hhv6foundation

A group at the University of Pennsylvania performed a retroactive study of 29 pediatric patients hospitalized with drug hypersensitivity reactions and found that those who reactivated with HHV-6 had longer lengths of stay (11.5 days vs. 5. days) and more severe illness. They were not able to determine the impact of steroid administration in HHV-6 positive patients.

Steroids increase HHV-6 but reduce EBV viral loads in DIHS/DRESS

In All, Drug Hypersensitivity, News by hhv6foundation

In a recent study published in the European Journal of Allergy and Clinical Immunology, a group from Kyorin University School of Medicine in Tokyo sought to comprehensively record the dynamics of key herpesviruses beyond the acute stage of SJS/TEN. While EBV loads were higher in patients not receiving systemic corticosteroids, CMV and HHV-6 loads were higher in those receiving them.

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GAD antibodies & HHV-6 limbic encephalitis – a case of molecular mimicry?

In All, Autoimmune Disease, CNS Disease, CNS Dysfunction, Encephalitis & Encephalopathy, Epilepsy and Seizures, Host Cell Interaction by Kristin Loomis

A fifth case of limbic encephalitis associated with GAD antibodies and HHV-6 infection has been reported, this time in an immunocompetent woman with chromosomally integrated HHV-6, epilepsy, and psychosis. The patient’s condition improved (with a drop in GAD antibody titers and stabilization of psychotic symptoms) in response to three weeks of antiviral therapy but relapsed when antiviral therapy was withdrawn.

View Post

Delirium associated with HHV-6B reactivation in cord blood transplant patients: time for an antiviral prophylaxis trial?

In All, Chronic Fatigue Syndrome, Cognitive Dysfunction, Encephalitis & Encephalopathy, Showcase, Transplant Complications by Kristin Loomis

A prospective study authored by Joshua Hill and Danielle Zerr determined that higher than average HHV-6B DNA levels increased the odds of developing delirium after cord blood transplantation (CBT) by almost three fold. Patients with DNA loads in the top quartile had a 4.5 fold increase in delirium.

See All Encephalitis & Encephalopathy Articles
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GAD antibodies & HHV-6 limbic encephalitis – a case of molecular mimicry?

In All, Autoimmune Disease, CNS Disease, CNS Dysfunction, Encephalitis & Encephalopathy, Epilepsy and Seizures, Host Cell Interaction by Kristin Loomis

A fifth case of limbic encephalitis associated with GAD antibodies and HHV-6 infection has been reported, this time in an immunocompetent woman with chromosomally integrated HHV-6, epilepsy, and psychosis. The patient’s condition improved (with a drop in GAD antibody titers and stabilization of psychotic symptoms) in response to three weeks of antiviral therapy but relapsed when antiviral therapy was withdrawn.

See All Epilepsy and Seizures Articles
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HSCT patients with HHV-6 reactivation have significantly worse survival rates and higher rates of acute GVHD

In All, GVHD, Transplant Complications by Kristin Loomis

A group from Sapporo Medical University studied 105 post HSCT patients and determined that 7 developed CNS dysfunction in the first 42 days after transplant. Six out of the 7 were positive for HHV-6, but none of the other 12 pathogens tested. Four or 3.8% of the population were diagnosed with HHV-6 encephalitis.

See All GVHD Articles
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Superinfection of HHV-6A in ciHHV6A patients with recurrent cardiac disease: a full genome analysis

In All, ciHHV-6, Genes & Proteins, Heart Disease, Latest Scientific News by Kristin Loomis

A group led by Ursula Gompels from the London School of Hygiene & Tropical Medicine, University of London, did next generation sequencing on three ciHHV6A cardiac patients and found superinfections of HHV-6A in two of the three. They characterized the first full genome sequence of ciHHV-6A and demonstrated the inherited ciHHV6 genome was similar but distinct from known exogenous (community acquired) strains of HHV-6A .

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Stanford uses non-invasive new assay to detect occult infections including HHV-6 after lung transplantion

In All, Heart Disease, News, Transplant Complications by Kristin Loomis

Researchers from Stanford University successfully used circulating cell-free DNA to identify infections in lung transplants that can often be found only with a more invasive transbronchial biopsy. This hypothesis free approach led to find HHV-6 & 7 at high levels in patients with infections, even though these viruses are not generally considered lung pathogens.

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HHV-6 myocarditis, pericarditis following transplantation

In All, Heart Disease, News, Transplant Complications by Kristin Loomis

A hematology group in Australia reported a case of biopsy-proven HHV-6 myocarditis post-hematopoietic stem cell transplantation (HSCT). he post-mortem exam confirmed dilated cardiomyopathy and focal changes consistent with viral myocarditis and cardiac tissue was positive for HHV-6 DNA by nested and quantitative PCR. Separately, A Japanese group reported a worman who developed pericarditis with over 10,000 copies/ml of HHV-6 DNA in the pericardial fluid, after a cord blood transplant.

CiHHV-6A is the dominant virus in malignancy and inflammatory disease cases, while ciHHV-6B is the dominant virus in myocarditis cases

In All, ciHHV-6, Heart Disease, News by hhv6foundation

A sequencing study led by Ursula Gompels of London School of Hygiene & Tropical Medicine, found that 95% (19/21) of Czech ciHHV-6 malignancy and inflammatory disease patients had ciHHV6A while 65% (13/20) of a German myocarditis cohort had ciHHV-6B. The authors propose that this divergence suggests different disease links for the two viruses.

See All Heart Disease Articles

HHV-6 and EBV elevated in the GI tract of HIV+ patients

In All, HIV/AIDS Progression, News by hhv6foundation

A group from Sapienza University in Rome has found a significantly elevated prevalence of HHV-6 and a higher viral load for EBV in the stomach and duodenum biopsies of patients with HIV compared to controls, suggesting that these viruses may contribute to the development of gastric cancer in immunocompromised patients.

See All HIV/AIDS Progression Articles

HHV-6 induced kidney damage in drug hypersensitivity

In Drug Hypersensitivity, Kidney Disease by hhv6foundation

A new case study suggests that HHV-6 might play a role in the multi-organ failure that often follows extreme cases of drug hypersensitivity. Although there have been many studies documenting HHV-6 viremia in drug hypersensitivity (DIHS/DRESS) cases, this is the first to examine an affected organ for signs of HHV-6 DNA and proteins. The mortality rate from severe drug hypersensitivity is approximately 10%, and death usually results from a late flare in symptoms and failure of one or more organ, typically the liver, kidney, lungs or heart. HHV-6 viremia occurs in the majority of extreme drug hypersensitivity cases (Pritchett 2012) but the reason for the disproportionate reactivation of HHV-6 is not understood. The case, which is presented by a Japanese …

See All Kidney Disease Articles
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Does CD134 upregulation explain why HHV-6 reactivates preferentially in DRESS/ DIHS?

In All, Drug Hypersensitivity, Latest Scientific News, Skin Conditions, Transplant Complications by Kristin Loomis

It has long been a mystery why HHV-6 is preferentially reactivated in drug reaction with eosinophilia and systemic symptoms (DRESS), also known as drug induced hypersensitivity syndrome (DIHS). HHV-6 reactivation occurs in over 60% of severe cases and is part of the definition of DIHS in Japan. Investigators in Japan suspect that the explanation may lie with the CD134 receptor on activated CD4 cells.

View Post

HHV-6 & 7 found in spinal fluid of immunocompetent children suspected of CNS infection

In All, CNS Disease, CNS Dysfunction, Latest Scientific News by Kristin Loomis

An Italian study on immunocompetent children with suspected CNS infections found HHV-6 and HHV-7 DNA in 4.2% and 4.8% of 304 cerebrospinal fluid (CSF) samples, respectively. Although once considered rare in the immunocompetent, recent studies with more sensitive methods have found HHV-6 in the CSF of 4-17% of immunocompetent children with seizures or suspected CNS infections.

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Superinfection of HHV-6A in ciHHV6A patients with recurrent cardiac disease: a full genome analysis

In All, ciHHV-6, Genes & Proteins, Heart Disease, Latest Scientific News by Kristin Loomis

A group led by Ursula Gompels from the London School of Hygiene & Tropical Medicine, University of London, did next generation sequencing on three ciHHV6A cardiac patients and found superinfections of HHV-6A in two of the three. They characterized the first full genome sequence of ciHHV-6A and demonstrated the inherited ciHHV6 genome was similar but distinct from known exogenous (community acquired) strains of HHV-6A .

View Post

Virus specific immunotherapy used for patients with primary immune deficiencies

In All, Immunology, Latest Scientific News, Transplant Complications, Treatments - Adoptive T cell by Kristin Loomis

A retrospective review led by Dr. Jordan Orange of Baylor College of Medicine was undertaken to determine the safety and efficacy of treatment with viral-specific T lymphocytes (VSTs) in patients with primary immunodeficiencies (PIDs). The group analyzed 36 patients who were treated with one or more VST infusions before (in 2 cases) or after undergoing hematopoietic stem cell transplantation (HSCT), and outcomes were found to be positive in the majority of patients.

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New research shows HLA modulation caused by acute HHV-6A infection of mesothelial cells

In All, Endocrine Conditions, Latest Scientific News, Multiple Sclerosis, Thyroid Disease by Kristin Loomis

HHV-6A infection of mesothelial cells causes HLA molecule modulation. This study demonstrates, for the first time, that human mesothelial cells are susceptible to HHV-6A infection. They also show that the virus causes modulated HLA expression on the cell surface, inducing the de novo expression of HLA class II and HLA-G

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Joshua Hill awarded a 5-year grant to study HHV-6

In All, Latest Scientific News by hhv6foundation

Congratulations to Joshua Hill, MD, Acting Instructor at the University of Washington and Research Associate at the Fred Hutchinson Cancer Research Center, who has won a K23 grant from the National Institute of Allergy and Infectious Diseases to study HHV-6 in lower respiratory tract disease and chromosomally integrated HHV-6 after stem cell transplantation (SCT).

Special Issue on Roseoloviruses!

In All, Featured, Latest Scientific News by hhv6foundation

The December 2014 issue of Current Opinions in Virology features a “Special Section on Roseoloviruses.” Top experts in the field contributed a set of 14 reviews that span a wide range of critical topics encompassing the molecular biology and the

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Drug-induced liver injury and HHV-6 reactivation without rash or fever

In All, Liver Disease, Transplant Complications by Kristin Loomis

Another case of drug induced liver injury accompanied by HHV-6 reactivation has been reported in Japan, the second such case without exanthema to be described. An earlier case was reported last year (Fujita 2015). The authors suggest that drug-induced liver injury cases be investigated for HHV-6 reactivation when liver dysfunction begins several weeks after the initiation of a new drug typically associated with hypersensitivity syndromes.

See All Liver Disease Articles
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HHV-6 can cause “idiopathic” pneumonia

In All, Lung Disease, News by hhv6foundation

A pivotal study, led by Michael Boeckh at the Fred Hutchinson Cancer Research Center, has determined that occult infections contribute to 57% of all cases of “idiopathic” pneumonia syndrome (IPS), a condition previously assumed to be non-infectious. HHV-6 was the dominant pathogen representing 29% of cases.

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New research shows HLA modulation caused by acute HHV-6A infection of mesothelial cells

In All, Endocrine Conditions, Latest Scientific News, Multiple Sclerosis, Thyroid Disease by Kristin Loomis

HHV-6A infection of mesothelial cells causes HLA molecule modulation. This study demonstrates, for the first time, that human mesothelial cells are susceptible to HHV-6A infection. They also show that the virus causes modulated HLA expression on the cell surface, inducing the de novo expression of HLA class II and HLA-G

HHV-6 status determines effectiveness of interferon treatment in Multiple Sclerosis

In All, Multiple Sclerosis, Uncategorized by hhv6foundation

The administration of immune agents to patients (known as Interferon-Beta-1b, or IFN-beta, therapy) has been widely used in the treatment and maintenance of multiple sclerosis (MS). Additionally, it is known that the risk of MS exacerbation is much higher in patients with active HHV-6 infection than in patients with a latent infection of the virus (Lafuente 2006, 2007; Chapenko 2003). In this new study from Madrid, researchers examined the effectiveness of IFN-1b therapy in multiple sclerosis patients with active HHV-6 infection. By monitoring the HHV-6 DNA levels of MS patients undergoing IFN-beta therapy, investigators were able to find that patients with active HHV-6 infection had a higher risk of severe MS relapse and poor response to IFN-beta therapy than patients …

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Specific NK Cell subsets Associated with HHV-6 Infection in Hashimoto’s Thyroiditis

In All, Endocrine Conditions, Thyroid Disease by Kristin Loomis

Human herpesvirus-6 (HHV-6) has been associated with several autoimmune diseases. A recent study led by Rizzo and Caselli have found a possible link to Hashimoto’s Thyroiditis (HT). They report that HHV-6 infection correlated with higher levels of a particular type of NK cell associated with a potent release of cytokines.

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New research shows HLA modulation caused by acute HHV-6A infection of mesothelial cells

In All, Endocrine Conditions, Latest Scientific News, Multiple Sclerosis, Thyroid Disease by Kristin Loomis

HHV-6A infection of mesothelial cells causes HLA molecule modulation. This study demonstrates, for the first time, that human mesothelial cells are susceptible to HHV-6A infection. They also show that the virus causes modulated HLA expression on the cell surface, inducing the de novo expression of HLA class II and HLA-G

See All Thyroid Disease Articles
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Does CD134 upregulation explain why HHV-6 reactivates preferentially in DRESS/ DIHS?

In All, Drug Hypersensitivity, Latest Scientific News, Skin Conditions, Transplant Complications by Kristin Loomis

It has long been a mystery why HHV-6 is preferentially reactivated in drug reaction with eosinophilia and systemic symptoms (DRESS), also known as drug induced hypersensitivity syndrome (DIHS). HHV-6 reactivation occurs in over 60% of severe cases and is part of the definition of DIHS in Japan. Investigators in Japan suspect that the explanation may lie with the CD134 receptor on activated CD4 cells.

View Post

Drug-induced liver injury and HHV-6 reactivation without rash or fever

In All, Liver Disease, Transplant Complications by Kristin Loomis

Another case of drug induced liver injury accompanied by HHV-6 reactivation has been reported in Japan, the second such case without exanthema to be described. An earlier case was reported last year (Fujita 2015). The authors suggest that drug-induced liver injury cases be investigated for HHV-6 reactivation when liver dysfunction begins several weeks after the initiation of a new drug typically associated with hypersensitivity syndromes.

View Post

Virus-specific immunotherapy for transplant patients with primary immune deficiencies

In All, Immunology, Transplant Complications, Treatments - Adoptive T cell by Kristin Loomis

A group from Baylor College of Medicine reviewed the efficacy of treating viral infections in transplant patients with primary immunodeficiencies using their viral-specific T lymphocytes. A total of 36 patients were treated with these immunotherapy infusions before or after undergoing hematopoietic stem cell transplantation, and a complete or partial antiviral response were seen in 86% of patients with CMV, 76% of patients with EBV and all patients with adenovirus or HHV-6.

View Post

Virus specific immunotherapy used for patients with primary immune deficiencies

In All, Immunology, Latest Scientific News, Transplant Complications, Treatments - Adoptive T cell by Kristin Loomis

A retrospective review led by Dr. Jordan Orange of Baylor College of Medicine was undertaken to determine the safety and efficacy of treatment with viral-specific T lymphocytes (VSTs) in patients with primary immunodeficiencies (PIDs). The group analyzed 36 patients who were treated with one or more VST infusions before (in 2 cases) or after undergoing hematopoietic stem cell transplantation (HSCT), and outcomes were found to be positive in the majority of patients.

View Post

Stanford uses non-invasive new assay to detect occult infections including HHV-6 after lung transplantion

In All, Heart Disease, News, Transplant Complications by Kristin Loomis

Researchers from Stanford University successfully used circulating cell-free DNA to identify infections in lung transplants that can often be found only with a more invasive transbronchial biopsy. This hypothesis free approach led to find HHV-6 & 7 at high levels in patients with infections, even though these viruses are not generally considered lung pathogens.

View Post

HHV-6 myocarditis, pericarditis following transplantation

In All, Heart Disease, News, Transplant Complications by Kristin Loomis

A hematology group in Australia reported a case of biopsy-proven HHV-6 myocarditis post-hematopoietic stem cell transplantation (HSCT). he post-mortem exam confirmed dilated cardiomyopathy and focal changes consistent with viral myocarditis and cardiac tissue was positive for HHV-6 DNA by nested and quantitative PCR. Separately, A Japanese group reported a worman who developed pericarditis with over 10,000 copies/ml of HHV-6 DNA in the pericardial fluid, after a cord blood transplant.

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HHV-6 the only pathogen identified in early post-transplant CNS dysfunction

In All, CNS Dysfunction, News, Transplant Complications by Kristin Loomis

A group from Sapporo Medical University studied 105 post HSCT patients and determined that 7 developed CNS dysfunction in the first 42 days after transplant. Six out of the 7 were positive for HHV-6, but none of the other 12 pathogens tested. Four patients (3.8%) were diagnosed with HHV-6 encephalitis. The group used a qualitative multiplex PCR and then used a quantitative PCR to confirm the results.

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Delirium associated with HHV-6B reactivation in cord blood transplant patients: time for an antiviral prophylaxis trial?

In All, Chronic Fatigue Syndrome, Cognitive Dysfunction, Encephalitis & Encephalopathy, Showcase, Transplant Complications by Kristin Loomis

A prospective study authored by Joshua Hill and Danielle Zerr determined that higher than average HHV-6B DNA levels increased the odds of developing delirium after cord blood transplantation (CBT) by almost three fold. Patients with DNA loads in the top quartile had a 4.5 fold increase in delirium.

View Post

HSCT patients with HHV-6 reactivation have significantly worse survival rates and higher rates of acute GVHD

In All, GVHD, Transplant Complications by Kristin Loomis

A group from Sapporo Medical University studied 105 post HSCT patients and determined that 7 developed CNS dysfunction in the first 42 days after transplant. Six out of the 7 were positive for HHV-6, but none of the other 12 pathogens tested. Four or 3.8% of the population were diagnosed with HHV-6 encephalitis.

See All Transplant Complications Articles
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Virus-specific immunotherapy for transplant patients with primary immune deficiencies

In All, Immunology, Transplant Complications, Treatments - Adoptive T cell by Kristin Loomis

A group from Baylor College of Medicine reviewed the efficacy of treating viral infections in transplant patients with primary immunodeficiencies using their viral-specific T lymphocytes. A total of 36 patients were treated with these immunotherapy infusions before or after undergoing hematopoietic stem cell transplantation, and a complete or partial antiviral response were seen in 86% of patients with CMV, 76% of patients with EBV and all patients with adenovirus or HHV-6.

View Post

Virus specific immunotherapy used for patients with primary immune deficiencies

In All, Immunology, Latest Scientific News, Transplant Complications, Treatments - Adoptive T cell by Kristin Loomis

A retrospective review led by Dr. Jordan Orange of Baylor College of Medicine was undertaken to determine the safety and efficacy of treatment with viral-specific T lymphocytes (VSTs) in patients with primary immunodeficiencies (PIDs). The group analyzed 36 patients who were treated with one or more VST infusions before (in 2 cases) or after undergoing hematopoietic stem cell transplantation (HSCT), and outcomes were found to be positive in the majority of patients.

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