Although depleting naïve T cells has been successful in preventing acute graft vs host disease in several studies, investigators from Spain reported an unexpectedly high incidence of HHV-6 encephalitis in a cohort of haploidentical transplant patients.
German investigators conducted a broad scale analysis of CD8 T cell responses to HHV-6B, identifying novel epitopes with potential for immunotherapy or vaccines. The strongest responses were directed against an epitope from IE-2.
Investigators at the University of Minnesota found that cord blood transplant cancer patients with HHV-6B reactivation in the first 28 days are almost 4x more likely to relapse in the first two years compared to those with no early reactivation.
HHV-6B directly infects thymocytes, presumably affecting thymopoeisis. A review in Bone Marrow Transplantation explores the intriguing relationship between HHV-6B, T-cell reconstitution and aGVHD after allogenic hematopoietic cell transplantation.
Dutch investigators found that hematopoietic cell transplant patients with high levels of HHV-6 viremia have reduced late immune reconstitution while early reconstitution was not affected.
HIV+ patients on antiretrovrial therapy with high levels of HHV-6 shedding had lower levels of IL-6 and other inflammatory markers. While HIV+ patients had increased shedding of EBV and CMV, there was no difference in shedding between patients and controls for HHV-6.
“Off-the-shelf” donor T cells primed to fight five specific viruses were shown to be effective in a Phase 2 trial backed by Viracyte. A single infusion produced a complete or partial response rate of 92%.
Growing evidence implicates HHV-6, especially HHV-6A, in some cases of female infertility, miscarriage, and other gestational problems affecting both the mother and child. The authors of the paper wonder if heparin, an anticoagulant with antiviral properties often used to treat infertility, might mitigate the detrimental effects of HHV-6 in the uterine environment.
A group from Hebrew University of Jerusalem has discovered the mechanism by cells with actively replicating HHV-6 evade elimination by natural killer (NK) cells.
Italian investigators found that 87% of patients with HHV-6 reactivations went on to develop a CMV infection. On the other hand, in patients who did not reactivate with HHV-6, only 33% developed an active CMV infection.
Only 11% of HHV-6 reactivated patients with poor immune reconstitution survived compared to 63% in patients with higher levels of T cells (or over 200 CD3+ lymphocytes per microliter).
A Spanish study of drug-induced eosinophilia found that early hypogammaglobulinemia was associated with subsequent HHV-6 reactivation in patients with severe drug hypersensitivity syndromes. This study of 274 cases at La Paz University Hospital in Madrid confirms earlier reports from Japan and France that described transient reductions of total IgG at the outset of drug hypersensitivity reactions leading to HHV-6 reactivation.
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.
Instead of using the traditional epitope mapping approach to identify major targets of the T cell response to a complex pathogen, a group from the University of Massachusetts used mass spectrometry to identify viral proteins associated with immunodominant antigens.
In a French study of 366 adult allogenic hematopeietic stem cell transplantation (aHSCT) recipients CD8+ T cell recovery was significantly reduced in patients with HHV-6 reactivation. HHV-6 reactivation was also associated with reduced survival and increased infections of CMV and BKV.
- Page 1 of 2