A combination of studies find that both reactivation and disease are infrequent after CAR-T therapy.
Centrilobular necroinflammation associated with pediatric HHV-6+ acute liver failure
Would early treatment with antiviral therapy prevent the need for a liver transplant?
Why does substituting CMV-specific letermovir for broad-spectrum anti-viral prophylaxis reduce the rate of HHV-6B encephalitis?
Japanese study replicates the paradoxical results of a prior US study, but fails to explain the paradox.
Reactivation of a transplant recipient’s iciHHV-6B resulted in an active infection of his donated liver
Investigators from the University of Helsinki used highly sophisticated techniques to establish that the donor’s integrated virus reactivated and then infected the graft. This thorough investigation highlights the potential pathological impact of iciHHV-6B in transplantation.
Biofire multiplex PCR assay accurately detects HHV-6 meningitis/encephalitis in immunocompromised adults
Utility of the assay in immunocompetent patients requires further study.
Reactivated HHV-6, CMV, adenovirus and BK virus associated with increased mortality in pediatric sepsis
Odds of mortality were 2.6-3X higher in patients with detectable viral DNA; odds were even higher with multiple herpesviruses.
Japanese study confirms cognitive problems from post-transplant HHV-6B reactivation
Those with the highest viral loads suffered deficits in verbal memory and reduced quality of life.
Adding antithymocyte globulin to post transplant cyclophosphamide prophylaxis does not increase risk of HHV-6 reactivation after haploidentical hematopoietic cell transplantation
The main risk factor for HHV-6 reactivation was low absolute lymphocyte count.
Strong Evidence Linking HHV-6B To Pneumonia in Transplant Patients
Levels of mRNA transcripts indicating active infection strengthen case for pathogenic role.
Substituting letermovir for broad-spectrum ganciclovir for CMV prophylaxis did not increase HHV-6 disease in allogenic transplant patients
Investigators were surprised that the use of the less toxic CMV specific antiviral did not result in a significant increase in HHV-6-related disease.
Phase III trials suspended for T-cell therapeutic active against HHV-6
In a surprise, multi-virus cytotoxic T cell therapy trials were terminated early for failure to meet endpoints.
Part 1: Latent HHV-6 is reactivated in patients receiving CAR-T cell therapy
Investigators urge careful monitoring for HHV-6 and ciHHV-6.
Part 2: CAR-T cell therapy and its complications
Could some complications of CAR-T cell therapy be secondary to HHV-6 infection?
Part 3. HHV-6 Encephalitis in CAR-T Cell therapy
Clearly documented cases of HHV-6 encephalitis have been reported, but some are missed because they were classified as ICAN or because HHV-6 testing was not performed in patients with mental status changes.
Part 4. Might HHV-6 contribute to some cases of cytokine release syndrome, pneumonia, and cytopenias in CAR-T Cell therapy?
While unlikely to trigger the cytokine storm, HHV-6 infection may perpetuate it, and contribute directly to cytopenias and pneumonia.