Chromosomally integrated human herpesvirus-6 in transplant recipients

S. O. Lee, R. A. Brown, R. R. Razonable

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

Human herpesvirus-6 (HHV-6) is unique among human herpesviruses because of its ability to integrate into chromosomes. This entity, termed chromosomally integrated HHV-6 (CIHHV-6), is often mistaken for active infection and treated unnecessarily. The clinical significance of CIHHV-6 in transplant recipients is not defined. Herein, the clinical characteristics of 7 liver transplant patients with CIHHV-6 from our recent study, together with 14 other published cases of CIHHV-6 were reviewed. Of the 21 cases, CIHHV-6B was reported most commonly among solid organ transplant recipients, while CIHHV-6A was mostly seen in allogeneic hematopoietic stem cell recipients. None of the 21 patients developed clinical symptoms related to HHV-6 after transplantation. However, antiviral therapy was administered to 5 asymptomatic patients mistaken to have HHV-6 infection because of their very high HHV-6 DNA levels, 3 who developed symptomatic cytomegalovirus disease, and 1 with graft-versus-host disease that was mistaken for HHV-6 infection. In patients who received antiviral therapy, there was no apparent decline in HHV-6 DNA load, although change in viral kinetics is difficult to discern in the setting of high baseline HHV-6 DNA load. Clinicians should be aware of this entity of CIHHV-6 so that antiviral therapy can be considered in the proper clinical context.

Original languageEnglish (US)
Pages (from-to)346-354
Number of pages9
JournalTransplant Infectious Disease
Volume14
Issue number4
DOIs
StatePublished - Aug 1 2012

Keywords

  • Chromosomal integration
  • Human herpesvirus-6
  • Prevalence
  • Transplantation

ASJC Scopus subject areas

  • Infectious Diseases
  • Transplantation

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