Chromosomally integrated human herpesvirus 6: Questions and answers

Philip E. Pellett; Dharam V. Ablashi; Peter F. Ambros; Henri Agut; Mary T. Caserta; Vincent Descamps; Louis Flamand; Agnès Gautheret-Dejean; Caroline B. Hall; Rammurti T. Kamble; Uwe Kuehl; Dirk Lassner; Irmeli Lautenschlager; Kristin S. Loomis; Mario Luppi; Paolo Lusso; Peter G. Medveczky; Jose G. Montoya; Yasuko Mori; Masao Ogata; Joshua C. Pritchett; Sylvie Rogez; Edward Seto; Katherine N. Ward; Tetsushi Yoshikawa; Raymund R. Razonable

doi:10.1002/rmv.715

Chromosomally integrated human herpesvirus 6: Questions and answers

Philip E. Pellett, Dharam V. Ablashi, Peter F. Ambros, Henri Agut, Mary T. Caserta, Vincent Descamps, Louis Flamand, Agnès Gautheret-Dejean, Caroline B. Hall, Rammurti T. Kamble, Uwe Kuehl, Dirk Lassner, Irmeli Lautenschlager, Kristin S. Loomis, Mario Luppi, Paolo Lusso, Peter G. Medveczky, Jose G. Montoya, Yasuko Mori, Masao OgataJoshua C. Pritchett, Sylvie Rogez, Edward Seto, Katherine N. Ward, Tetsushi Yoshikawa, Raymund R. Razonable

Infectious Diseases

Research output: Contribution to journal › Review article › peer-review

233 Scopus citations

Abstract

Chromosomally integrated human herpesvirus 6 (ciHHV-6) is a condition in which the complete HHV-6 genome is integrated into the host germ line genome and is vertically transmitted in a Mendelian manner. The condition is found in less than 1% of controls in the USA and UK, but has been found at a somewhat higher prevalence in transplant recipients and other patient populations in several small studies. HHV-6 levels in whole blood that exceed 5.5 log10 copies/ml are strongly suggestive of ciHHV-6. Monitoring DNA load in plasma and serum is unreliable, both for identifying and for monitoring subjects with ciHHV-6 due to cell lysis and release of cellular DNA. High HHV-6 DNA loads associated with ciHHV-6 can lead to erroneous diagnosis of active infection. Transplant recipients with ciHHV-6 may be at increased risk for bacterial infection and graft rejection. ciHHV-6 can be induced to a state of active viral replication in vitro. It is not known whether ciHHV-6 individuals are put at clinical risk by the use of drugs that have been associated with HHV-6 reactivation in vivo or in vitro. Nonetheless, we urge careful observation when use of such drugs is indicated in individuals known to have ciHHV-6. Little is known about whether individuals with ciHHV-6 develop immune tolerance for viral proteins. Further research is needed to determine the role of ciHHV-6 in disease.

Original language	English (US)
Pages (from-to)	144-155
Number of pages	12
Journal	Reviews in Medical Virology
Volume	22
Issue number	3
DOIs	https://doi.org/10.1002/rmv.715
State	Published - May 2012

ASJC Scopus subject areas

Virology
Infectious Diseases

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10.1002/rmv.715

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Pellett, P. E., Ablashi, D. V., Ambros, P. F., Agut, H., Caserta, M. T., Descamps, V., Flamand, L., Gautheret-Dejean, A., Hall, C. B., Kamble, R. T., Kuehl, U., Lassner, D., Lautenschlager, I., Loomis, K. S., Luppi, M., Lusso, P., Medveczky, P. G., Montoya, J. G., Mori, Y., ... Razonable, R. R. (2012). Chromosomally integrated human herpesvirus 6: Questions and answers. Reviews in Medical Virology, 22(3), 144-155. https://doi.org/10.1002/rmv.715

Pellett, PE, Ablashi, DV, Ambros, PF, Agut, H, Caserta, MT, Descamps, V, Flamand, L, Gautheret-Dejean, A, Hall, CB, Kamble, RT, Kuehl, U, Lassner, D, Lautenschlager, I, Loomis, KS, Luppi, M, Lusso, P, Medveczky, PG, Montoya, JG, Mori, Y, Ogata, M, Pritchett, JC, Rogez, S, Seto, E, Ward, KN, Yoshikawa, T & Razonable, RR 2012, 'Chromosomally integrated human herpesvirus 6: Questions and answers', Reviews in Medical Virology, vol. 22, no. 3, pp. 144-155. https://doi.org/10.1002/rmv.715

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title = "Chromosomally integrated human herpesvirus 6: Questions and answers",

abstract = "Chromosomally integrated human herpesvirus 6 (ciHHV-6) is a condition in which the complete HHV-6 genome is integrated into the host germ line genome and is vertically transmitted in a Mendelian manner. The condition is found in less than 1% of controls in the USA and UK, but has been found at a somewhat higher prevalence in transplant recipients and other patient populations in several small studies. HHV-6 levels in whole blood that exceed 5.5 log10 copies/ml are strongly suggestive of ciHHV-6. Monitoring DNA load in plasma and serum is unreliable, both for identifying and for monitoring subjects with ciHHV-6 due to cell lysis and release of cellular DNA. High HHV-6 DNA loads associated with ciHHV-6 can lead to erroneous diagnosis of active infection. Transplant recipients with ciHHV-6 may be at increased risk for bacterial infection and graft rejection. ciHHV-6 can be induced to a state of active viral replication in vitro. It is not known whether ciHHV-6 individuals are put at clinical risk by the use of drugs that have been associated with HHV-6 reactivation in vivo or in vitro. Nonetheless, we urge careful observation when use of such drugs is indicated in individuals known to have ciHHV-6. Little is known about whether individuals with ciHHV-6 develop immune tolerance for viral proteins. Further research is needed to determine the role of ciHHV-6 in disease.",

author = "Pellett, {Philip E.} and Ablashi, {Dharam V.} and Ambros, {Peter F.} and Henri Agut and Caserta, {Mary T.} and Vincent Descamps and Louis Flamand and Agn{\`e}s Gautheret-Dejean and Hall, {Caroline B.} and Kamble, {Rammurti T.} and Uwe Kuehl and Dirk Lassner and Irmeli Lautenschlager and Loomis, {Kristin S.} and Mario Luppi and Paolo Lusso and Medveczky, {Peter G.} and Montoya, {Jose G.} and Yasuko Mori and Masao Ogata and Pritchett, {Joshua C.} and Sylvie Rogez and Edward Seto and Ward, {Katherine N.} and Tetsushi Yoshikawa and Razonable, {Raymund R.}",

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T2 - Questions and answers

AU - Pellett, Philip E.

AU - Ablashi, Dharam V.

AU - Ambros, Peter F.

AU - Agut, Henri

AU - Caserta, Mary T.

AU - Descamps, Vincent

AU - Flamand, Louis

AU - Gautheret-Dejean, Agnès

AU - Hall, Caroline B.

AU - Kamble, Rammurti T.

AU - Kuehl, Uwe

AU - Lassner, Dirk

AU - Lautenschlager, Irmeli

AU - Loomis, Kristin S.

AU - Luppi, Mario

AU - Lusso, Paolo

AU - Medveczky, Peter G.

AU - Montoya, Jose G.

AU - Mori, Yasuko

AU - Ogata, Masao

AU - Pritchett, Joshua C.

AU - Rogez, Sylvie

AU - Seto, Edward

AU - Ward, Katherine N.

AU - Yoshikawa, Tetsushi

AU - Razonable, Raymund R.

PY - 2012/5

Y1 - 2012/5

N2 - Chromosomally integrated human herpesvirus 6 (ciHHV-6) is a condition in which the complete HHV-6 genome is integrated into the host germ line genome and is vertically transmitted in a Mendelian manner. The condition is found in less than 1% of controls in the USA and UK, but has been found at a somewhat higher prevalence in transplant recipients and other patient populations in several small studies. HHV-6 levels in whole blood that exceed 5.5 log10 copies/ml are strongly suggestive of ciHHV-6. Monitoring DNA load in plasma and serum is unreliable, both for identifying and for monitoring subjects with ciHHV-6 due to cell lysis and release of cellular DNA. High HHV-6 DNA loads associated with ciHHV-6 can lead to erroneous diagnosis of active infection. Transplant recipients with ciHHV-6 may be at increased risk for bacterial infection and graft rejection. ciHHV-6 can be induced to a state of active viral replication in vitro. It is not known whether ciHHV-6 individuals are put at clinical risk by the use of drugs that have been associated with HHV-6 reactivation in vivo or in vitro. Nonetheless, we urge careful observation when use of such drugs is indicated in individuals known to have ciHHV-6. Little is known about whether individuals with ciHHV-6 develop immune tolerance for viral proteins. Further research is needed to determine the role of ciHHV-6 in disease.

AB - Chromosomally integrated human herpesvirus 6 (ciHHV-6) is a condition in which the complete HHV-6 genome is integrated into the host germ line genome and is vertically transmitted in a Mendelian manner. The condition is found in less than 1% of controls in the USA and UK, but has been found at a somewhat higher prevalence in transplant recipients and other patient populations in several small studies. HHV-6 levels in whole blood that exceed 5.5 log10 copies/ml are strongly suggestive of ciHHV-6. Monitoring DNA load in plasma and serum is unreliable, both for identifying and for monitoring subjects with ciHHV-6 due to cell lysis and release of cellular DNA. High HHV-6 DNA loads associated with ciHHV-6 can lead to erroneous diagnosis of active infection. Transplant recipients with ciHHV-6 may be at increased risk for bacterial infection and graft rejection. ciHHV-6 can be induced to a state of active viral replication in vitro. It is not known whether ciHHV-6 individuals are put at clinical risk by the use of drugs that have been associated with HHV-6 reactivation in vivo or in vitro. Nonetheless, we urge careful observation when use of such drugs is indicated in individuals known to have ciHHV-6. Little is known about whether individuals with ciHHV-6 develop immune tolerance for viral proteins. Further research is needed to determine the role of ciHHV-6 in disease.

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Chromosomally integrated human herpesvirus 6: Questions and answers

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