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
Failure to detect iciHHV-6 leads to overtreatment in hematopoietic cell transplant recipients
Mistaking iciHHV-6 for a marked reactivation of naturally-acquired infection can lead to unnecessary diagnostic procedures and treatments, with adverse effects.
Foscarnet prophylaxis improved engraftment and survival in cord blood transplant patients
Six-month overall survival was 96% in the treated group compared to 72% in the untreated group.
In DRESS/DIHS, early treatment with high dose steroids may suppress HHV-6; late treatment may prolong viremia
High dose steroids given in the first week appears to prevent HHV-6 reactivation in DRESS/DIHS patients by suppressing T-cell activation and serum interleukin-2 receptor (sIL-2R) levels. In contrast, a late start of steroid therapy resulted in a persistently high viral load for at least three weeks.
CMV & HHV-6 cause severe complications in non-transplant acute leukemia patients
Herpesvirus co-infections, particularly HHV-6 and CMV, cause severe lymphopenia, pneumonia, and an increased risk of acquiring bacterial and fungal infections in non-transplant acute leukemia patients undergoing chemotherapy.
Oral brincidofovir prophylaxis for CMV decreased incidence of HHV-6B viremia
Allogenic transplant patients who received prophylactic oral brincidofovir as part of a CMV trial had a reduced HHV-6B reactivation and lower viral loads.
Multiplex FilmArray Meningitis/Encephalitis assay is useful for diagnosing HHV-6 encephalitis
This multiplex qualitative test for cerebrospinal fluid helps physicians diagnose HHV-6 encephalitis quickly, but interpretation must take into account imaging, ciHHV-6 status and other markers.
New humanized mouse model mimics HHV-6B pathogenesis
Researchers led by Yasuko Mori of Kobe University in Japan have developed an animal model will be useful for studying the pathogenicity of HHV-6B in conditions such as acute GVHD and idiopathic pneumonia
Low sodium or SIADH may be an early indicator of HHV-6 encephalitis
A systematic review suggests that sodium imbalance is associated with HHV-6 encephalitis and syndrome of inappropriate diuretic hormone (SIADH) could serve as an early warning
Patients with iciHHV-6 have higher inflammatory cytokines and develop acute graft vs host disease a week earlier
Transplant patients born with chromosomally integrated HHV-6 have elevated levels of C-reactive protein and tumor necrosis factor receptor 1, both markers associated with increased risk of acute graft-versus-host disease.
European guidelines published for diagnosing, preventing, and managing HHV-6 disease
European guidelines recommend treating HHV-6 disease with either foscarnet or ganciclovir, in contrast to the Japanese guidelines that recommend foscarnet as first line treatment due to a lower mortality rate.
HHV-6B lung infection doubles the mortality rate of transplant patients with respiratory disease
Investigators at the Fred Hutchinson Cancer Research Center and University of Washington in Seattle found that HHV-6B in lung fluid of bone marrow transplant recipients with pneumonia is associated with a 2-fold increased risk of death. Importantly, HHV-6B positive patients who were treated with an antiviral had a 60% lower risk of death.
HHV-6 found in 22% of acute liver failure of “unknown etiology”
A third of patients with acute liver failure were found to have a betaherpesvirus infection when tested for all herpesviruses. HHV-6 was the most common infection, followed by CMV and HHV-7. No other herpesviruses were found.
HHV-6 DNA in bile fluid correlates with higher mortality in liver transplant patients
Persistent HHV-6 infection in the liver is hard to detect from plasma samples and liver biopsies may miss spotty infections. Bile fluid may be the best method for detecting herpesviruses that impact the liver.
HHV-6 encephalitis: Mayo clinic finds a high rate of severe hippocampal atrophy and neurological deficits
A Mayo clinic review of long-term outcome of patients with HHV-6 encephalitis showed that over 60% showed persistent sequelae associated with severe bilateral hippocampal atrophy. Symptoms included anterograde amnesia, aphasia, headaches, confusion and persistent memory deficits.