The University of Washington and the Fred Hutchinson Cancer Research Center are at the forefront of studying the role of HHV-6 and ciHHV-6 in stem cell transplant patients. We asked their view on the implications immunocompromised patients with integrated HHV-6A reactivating with their own inherited virus.
Immunocompetent adults are not supposed to get HHV-6 encephalitis or status epilepticus (SE) and HHV-6 testing is rarely performed in these patients. A new case report from Baylor suggests that testing for HHV-6 in these patients may be worthwhile.
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.
The inherited strain of HHV-6A in an immunosuppressed infant activated and caused hemophagocytic syndrome that was responsive to antiviral treatment. The isolated strain matched that of his ciHHV6 father.
Drs. Ishida and Shiohara from Kyorin University in Tokyo have publised an inportant new study on the dynamics of herpesvirus reactivations during and after severe drug reactions. We asked them their thoughts on the implications of their findings.
A group led by Takashi Ichiyama has determined that serum levels of both matrix metallopreinase-9 and tissue inhibitor of metalloproeinases-1 are significantly elevated in infants with HHV-6 infection compared to controls, leading to a dysfunction of the blood brain barrier.
Patients with HHV-6 induced encephalopathy or AESD suffer from severe oxidative stress. Edaravone shows promise for reducing oxidation and neuronal damage in a condition that leaves 70% with permanent disability.
A report published by a group from the University of Minnesota details the case of a 59-year-old male who developed non-convulsive status epilepticus and hyponatremia in addition to HHV-6 reactivation following umbilical cord blood transplantation.
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.
Should physicians automatically discount HHV-6 if any other pathogen is found in the CSF? Should patients with both HHV-6 and EBV DNA in the CSF be treated only for EBV? These are the questions that UW group tried to sort out in this study.
The HHV-6 Foundation in a non-profit entity founded to encourage scientific exchange between investigators and to provide pilot grants for promising scientific and clinical research on the under- appreciated viruses HHV-6A and HHV-6B. The Foundation sponsors international conferences and supports scientists and clinicians seeking to clarify the role of the two HHV-6 viruses in disease. Since the HHV-6A and HHV-6B can smolder in the brain and other organs without circulating in the peripheral blood or plasma, identifying chronic infection is a challenge.
ciHHV-6 Patient Registry
Except for transplant patients, HHV-6 plasma DNA tests are rarely positive. Any patient testing positive should rule out chromosomally integrated HHV-6, a condition that may be associated with increased HHV-6 reactivation.