Stanford investigators found that high levels of HHV-6 viremia following allogeneic stem cell transplants were associated end organ disease and greater non-relapse mortality.
HHV-6 in end organ disease: liver transplantation and inflammatory cardiomyopathy in immunocompetent children
Two reviews have been published on the roles of HHV-6 in liver transplantation and in pediatric inflammatory cardiomyopathy in the immunocompetent. Both reviews stress the importance of biopsies for diagnosis since HHV-6 DNA is rarely found in the plasma in spite of persistent reactivation in the organ.
Review of HHV-6 induced inflammatory cardiomyopathy in immunocompetent children
Although only a small number of pediatric cases have been reported in literature, the authors conclude that evidence suggests HHV-6 should be considered as a causative agent of inflammatory cardiomyopathy, particularly in young children (under 3 years of age) who might be experiencing a primary infection.
Superinfection of HHV-6A in ciHHV6A patients with recurrent cardiac disease: a full genome analysis
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 .
Fatal HHV-6 pediatric myocarditis following immunosuppression
A case report published by a group at the University of Minnesota details two cases of fatal myocarditis associated with HHV-6 in two immunosuppressed children.
Stanford uses non-invasive new assay to detect occult infections including HHV-6 after lung transplantion
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.
HHV-6 myocarditis, pericarditis following transplantation
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.
HHV-6, enterovirus and parvovirus B-19 DNA found in the blood of immunocompetent infants with myocarditis
80% of infants with myocarditis were positive for a cardiotropic virus compared to less than 4% of healthy controls, according to a multicenter study led by researchers at Washington University in St. Louis. This was a far higher rate than in older children.
ciHHV-6 is a risk factor for angina pectoris
In an article published this month in the Proceedings of the National Academy of Sciences, Dr. Louis Flamand’s team has described a relationship between inherited chromosomally integrated HHV-6 (iciHHV-6) and the development of angina pectoris.
Heart failure worsens in patients with persistent HHV-6B positive biopsies
Numerous case reports and studies have now tied HHV-6 to myocarditis and cardiomyopathies. To further investigate this relationship, investigators from one of the top cardiology clinics in Europe performed a study to determine the outcome of patients discovered to have HHV-6 in their cardiac tissue during the initial biopsy screen.
CiHHV-6A is the dominant virus in malignancy and inflammatory disease cases, while ciHHV-6B is the dominant virus in myocarditis cases
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.
Active ciHHV-6 linked to heart failure, a condition treatable by antiviral therapy
Berlin Charite study shows heart failure patients with active ciHHV-6 can be treated successfully with antivirals.
Diagnosing infections in myocardial biopsies: Interview with Cardiologist Uwe Kühl and IKDT Lab Director Dirk Lassner
The cardiology clinic at the Campus Benjamin Franklin, Charité – University Medicine Berlin is recognized as leading center for using state-of-the art mRNA analysis to diagnose active infections the biopsy tissue of myocarditis and heart failure patients.
Another fatal case of HHV-6 myocarditis in an immunocompetent adult
Group suggests cardiac magnetic resonance (CMR) may be an important tool for the timely diagnosis
Successful use of Artesunate to treat HHV-6B myocarditis in a child
A group from Children’s Heart Centre in Lund, Sweden, has used Artesunate as an effective antiviral therapy to aid in the treatment of a child with HHV-6B myocarditis.
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