4.2 Article

Elevation of HHV-6 viral load mimicking HHV-6 reactivation after second umbilical cord blood transplantation in chromosomally integrated human herpesvirus-6

Journal

JOURNAL OF INFECTION AND CHEMOTHERAPY
Volume 27, Issue 10, Pages 1517-1519

Publisher

ELSEVIER
DOI: 10.1016/j.jiac.2021.05.016

Keywords

Chromosomally integrated human herpesvirus-6; Cord blood transplantation; HHV-6 mRNA

Funding

  1. JSPS KAKENHI [19K16811]

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This case report focuses on the behavior of HHV-6 in a patient with ciHHV-6 who underwent two CBTs. Changes in HHV-6 DNA levels in peripheral blood leukocytes during the disease course were observed, suggesting the potential release of HHV-6 genome due to tissue damage. Physicians should be aware of the variability of HHV-6 DNA during allogeneic hematopoietic stem cell transplantation in ciHHV-6 patients.
Human herpesvirus-6 (HHV-6) reactivation is an important complication in patients receiving umbilical cord blood transplantation (CBT). Chromosomally integrated human herpesvirus-6 (ciHHV-6) is a condition in which the complete HHV-6 genome is integrated into the host germline genome and is transmitted in a Mendelian manner. The influence of ciHHV-6 in recipients or donors in cases of CBT is unknown. We report the first case with ciHHV-6 that received CBT twice for acute lymphoblastic T-cell leukemia. HHV-6 DNA in peripheral blood leukocytes (PBLs) was examined over time through two CBTs. After the first CBT, the HHV-6 viral load was significantly reduced by conversion to PBLs derived from the first donor. During the second CBT, an increase in HHV-6 DNA in PBLs and plasma were observed. However, HHV-6 mRNA was not detected in either the sample before 2nd CBT or at the time of HHV-6 DNA elevation. It is considered that the HHV-6 DNA detected in PBLs and plasma samples might be the HHV-6 genome released due to tissue damage. This case suggests that physicians should be aware of HHV-6 DNA variability during allogeneic hematopoietic stem cell transplantation in ciHHV-6 patients.

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