Role for HHV-6 in patients with renal failure?
Previous studies have demonstrated that HHV-6 infection is associated with acute graft rejection among renal transplant recipients (Caiola 2012). However, a new study from UNIFESP in Brazil indicates that active HHV-6 infection may play a role in patients with renal failure prior to transplantation as well.
The group prospectively monitored HHV-6 infection in 30 kidney transplant patients, collecting samples from recipients and donors prior to transplantation, on a weekly basis for the first two months after transplantation, and every two weeks for an additional two months. Prior to transplantation, active HHV-6 replication was detected in 25% of recipients and in none of the donors. Risk factors for post-transplant active HHV-6 infection included receiving an organ from a living donor (P=.028), recipients IgM+ before transplantation (P=.005), and pretransplantation recipient HHV-6 viral load >10,000 copies/mL of plasma (P=.034).
Although the authors did not discuss the possibility of chromosomal integration, plasma levels of >10,000 HHV-6 copies are consistent with chromosomally integrated HHV-6 (ciHHV-6). It is quite possible therefore, that at least some of the patients with persistent high levels of HHV-6 in the plasma represent patients with the condition. Additional testing would be necessary to confirm these suspicions, as outlined by Pellet et al (Pellett 2011).
For more information, read the full paper here, and visit the HHV-6 Foundation webpage on HHV-6 in Kidney Disease.