Danielle M Zerr1. 1. Department of Pediatrics, University of Washington, Seattle Children's Hospital, Seattle, Washington 98115, USA. danielle.zerr@seattlechildrens.org
Abstract
PURPOSE OF REVIEW: Human herpesvirus 6 (HHV-6) frequently reactivates after solid-organ and hematopoietic cell transplantation (HCT), and it has been associated with important outcomes in these settings. In 1-2% of recipients or donors, HHV-6 was inherited through chromosomal integration. Although HHV-6 chromosomal integration has not been associated with disease, the resulting very high levels of HHV-6 DNA in human tissue and blood samples can be challenging to interpret in the transplant setting. This review addresses the recent findings regarding the clinical outcomes associated with HHV-6 as well as diagnostic and therapeutic concerns. RECENT FINDINGS: The evidence supports a causal association between HHV-6 and central nervous system disease. New studies have further characterized the impact of HHV-6 on the central nervous system. In addition, new studies have explored the associations between HHV-6 and other important outcomes. The implications of integrated HHV-6 in transplant recipients remain undefined, though the possibility of an association with organ rejection has been suggested. New exploratory data exist regarding the safety of antiviral prophylactic and preemptive strategies. SUMMARY: Our understanding of the full clinical impact of HHV-6 in the transplant population remains incomplete. A large antiviral trial would not only help to further define causality between HHV-6 associated clinical outcomes but also start to define preventive strategies.
PURPOSE OF REVIEW: Human herpesvirus 6 (HHV-6) frequently reactivates after solid-organ and hematopoietic cell transplantation (HCT), and it has been associated with important outcomes in these settings. In 1-2% of recipients or donors, HHV-6 was inherited through chromosomal integration. Although HHV-6 chromosomal integration has not been associated with disease, the resulting very high levels of HHV-6 DNA in human tissue and blood samples can be challenging to interpret in the transplant setting. This review addresses the recent findings regarding the clinical outcomes associated with HHV-6 as well as diagnostic and therapeutic concerns. RECENT FINDINGS: The evidence supports a causal association between HHV-6 and central nervous system disease. New studies have further characterized the impact of HHV-6 on the central nervous system. In addition, new studies have explored the associations between HHV-6 and other important outcomes. The implications of integrated HHV-6 in transplant recipients remain undefined, though the possibility of an association with organ rejection has been suggested. New exploratory data exist regarding the safety of antiviral prophylactic and preemptive strategies. SUMMARY: Our understanding of the full clinical impact of HHV-6 in the transplant population remains incomplete. A large antiviral trial would not only help to further define causality between HHV-6 associated clinical outcomes but also start to define preventive strategies.
Authors: Joshua A Hill; Michael J Boeckh; Ruth Hall Sedlak; Keith R Jerome; Danielle M Zerr Journal: J Clin Virol Date: 2014-07-12 Impact factor: 3.168
Authors: Xiaofeng Zhou; David N O'Dwyer; Meng Xia; Holly K Miller; Paul R Chan; Kelsey Trulik; Mathew M Chadwick; Timothy C Hoffman; Camille Bulte; Kevin Sekerak; Carol A Wilke; Swapneel J Patel; Wayne M Yokoyama; Susan Murray; Gregory A Yanik; Bethany B Moore Journal: Am J Respir Crit Care Med Date: 2019-07-01 Impact factor: 21.405
Authors: Enkhtsetseg Purev; Thomas Winkler; Robert L Danner; Gary A Fahle; Linda Cook; Danielle M Zerr; Keith R Jerome; Richard W Childs Journal: Blood Date: 2014-08-14 Impact factor: 22.113
Authors: M Ogata; K Oshima; T Ikebe; K Takano; H Kanamori; T Kondo; Y Ueda; T Mori; H Hashimoto; H Ogawa; T Eto; T Ueki; T Miyamoto; T Ichinohe; Y Atsuta; T Fukuda Journal: Bone Marrow Transplant Date: 2017-08-07 Impact factor: 5.483
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