Study finds value in HHV-6 testing of other tissues, as well as blood, and of routine testing for iciHHV-6 in both donors and recipients of allo-HCT.
Herpesvirus reactivation during alloHSCT associated with greatly increased mortality and expense
Data from 13,363 transplant patients underline the importance of preventing, diagnosing and treating viral reactivation.
Virus specific T cell infusions show promise for preventing HHV-6B reactivation in transplant patients
Review highlights the importance of cell mediated immunity and the limitations of antivirals, vaccines and immunoglobulin therapy for HHV-6, VZV and HSV.
Reference values established for virus specific T-cells in healthy adults
These values may help determine the type of treatment transplant patients should receive: antiviral or adoptive T-cell therapy or a reduction in immunosuppression.
HHV-6 encephalitis following CAR-T cell therapy
A growing number of case reports reveal reactivation similar to that seen after hematopoietic stem cell therapy. Could CAR-T cells be a source of lytic HHV-6?
Adding an adoptive NK cell infusion to naïve T-Cell-depleted grafts may reduce the rate of HHV-6B reactivation and encephalitis
A small pediatric study found that adoptive NK cell infusions eliminated HHV-6B encephalitis, while maintaining a low rate of GVHD. At a ratio of NK/CD4 >2, the HHV-6B reactivation rate dropped dramatically.
HHV-6 found to be the most frequent cause of viremia in children following HSCT
A prospective study of children transplanted for both malignant and nonmalignant disease found HHV-6 viremia in 53% of cases.
Evidence for HHV-6-induced thrombotic microangiopathy in transplant patients undergoing HSCT
Among infectious agents, HHV-6 was found to be an independent risk factor for thrombotic microangiopathy (TMA) and only HHV-6 infection was associated with TMA-related mortality.
Breakthrough reactivation of HHV-6 occurs with liver transplantation in spite of valganciclovir preemptive therapy for CMV
High-grade HHV-6 viremia is independently associated with rejection of liver transplants within 12 months
Adult patients with lower levels of anti-HHV-6 IgG are significantly more likely to experience HHV-6 reactivation following cord blood transplant
Patients with low levels of HHV-6 antibodies might benefit from treatment from IVIG or novel neutralizing antibodies before cord blood transplantation
Quantitative PCR of serum found superior to whole blood in differentiating between latent virus and viremia following cord blood transplantation
Use of serum more easily distinguishes viremia from latent virus
HHV-6 reactivation following haploidentical hematopoietic stem-cell transplant found to predict acute graft versus host disease in China
25% of the patients with HHV-6 reactivation developed aGVHD compared to 18% in those without reactivation.
Substantial reduction in hippocampal volume found in pediatric hematopoietic stem cell transplant patients with HHV-6B reactivation
Surprisingly, the damage from HHV-6B infection often occurred in the absence of obvious neurological symptoms. Patients without HHV-6 reactivation had no reduction in volume.
Telomeric integration, excision and subsequent and transmission in people with inherited chromosomally integrated HHV-6B (iciHHV-6B)
Exploiting a hypervariable region of the HHV-6B genome, investigators achieve new insights about integration, excision, and genomic stability of iciHHV-6B
Significantly worse outcomes in critically ill hematology patients associated with HHV-6 infection.
Two reports associate detectable HHV-6 DNA in body fluids with increased risk of mortality in patients being treated for hematologic malignancies.