These values may help determine the type of treatment transplant patients should receive: antiviral or adoptive T-cell therapy or a reduction in immunosuppression.
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?
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.
A prospective study of children transplanted for both malignant and nonmalignant disease found HHV-6 viremia in 53% of cases.
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.
High-grade HHV-6 viremia is independently associated with rejection of liver transplants within 12 months
Patients with low levels of HHV-6 antibodies might benefit from treatment from IVIG or novel neutralizing antibodies before cord blood transplantation
Use of serum more easily distinguishes viremia from latent virus
25% of the patients with HHV-6 reactivation developed aGVHD compared to 18% in those without 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.
Exploiting a hypervariable region of the HHV-6B genome, investigators achieve new insights about integration, excision, and genomic stability of iciHHV-6B
Two reports associate detectable HHV-6 DNA in body fluids with increased risk of mortality in patients being treated for hematologic malignancies.
Large, retrospective multi-institutional study of non-CMV herpesvirus infection in the HCT with cyclophosphamide prophylaxis finds higher rate of HHV-6 infection and associated higher mortality
Mistaking iciHHV-6 for a marked reactivation of naturally-acquired infection can lead to unnecessary diagnostic procedures and treatments, with adverse effects.
Six-month overall survival was 96% in the treated group compared to 72% in the untreated group.