Prevalence of Human Herpesvirus‐6 Chromosomal Integration (CIHHV‐6) in Italian Solid Organ and Allogeneic Stem Cell Transplant Patients

• Published in: American journal of transplantation Vol. 9; no. 7; pp. 1690 - 1697
• Main Authors: Potenza, L., Barozzi, P., Masetti, M., Pecorari, M., Bresciani, P., Gautheret‐Dejean, A., Riva, G., Vallerini, D., Tagliazucchi, S., Codeluppi, M., Di Benedetto, F., Gerunda, G. E., Narni, F., Torelli, G., Luppi, M.
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01.07.2009; Wiley
• Subjects: Adult; Allogeneic stem cell transplantation; Biological and medical sciences; chromosomal integration; Cohort Studies; DNA, Viral - blood; DNA, Viral - genetics; Epidemiology; General aspects; Herpesvirus 6, Human - genetics; Herpesvirus 6, Human - isolation & purification; Herpesvirus 6, Human - pathogenicity; Herpesvirus 6, Human - physiology; Human herpesvirus 6; Humans; Italy; Male; Medical sciences; Middle Aged; prevalence; Public health. Hygiene; Public health. Hygiene-occupational medicine; Roseolovirus Infections - diagnosis; Roseolovirus Infections - etiology; Roseolovirus Infections - virology; solid organ transplantation; Stem Cell Transplantation - adverse effects; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Transplantation, Homologous; Transplants - adverse effects; Viremia - diagnosis; Viremia - etiology; Viremia - virology; Virus Integration - genetics; Italy; Europe; Human; Integration; Italian; Prevalence; Stem cell; Hematopoietic cell; Homograft; Solid organ; Chromosome; Patient; Transplantation; Homotransplantation; Epidemiology; chromosomal integration; Treatment; Surgery; Graft; Genetics; solid organ transplantation; Human herpesvirus 6; Allogeneic stem cell transplantation
• ISSN: 1600-6135; 1600-6143
• DOI: 10.1111/j.1600-6143.2009.02685.x

The unique phenomenon of human herpesvirus‐6 (HHV‐6) chromosomal integration (CIHHV‐6) may account for clinical drawbacks in transplant setting, being misinterpreted as active infection and leading to unnecessary and potentially harmful treatments. We have investigated the prevalence of CIHHV‐6 in 205 consecutive solid organ (SO) and allogeneic stem cell transplant (alloSCT) Italian patients. Fifty‐two (38.5%) of 135 solid organ transplant (SOT) and 16 (22.8%) of 70 alloSCT patients resulted positive for plasma HHV‐6 DNA by real‐time polymerase chain reaction. Seven SOT and three alloSCT patients presented HHV‐6‐related diseases, requiring antivirals. Two further patients (0.9%) were identified, presenting high HHV‐6 loads. The quantification of HHV‐6 on hair follicles disclosed the integrated state, allowing the discontinuation of antivirals. Before starting specific treatments, CIHHV‐6 should be excluded in transplant patients with HHV‐6 viremia by the comparison of HHV‐6 loads on different fluids and tissues. Pretransplantation screening of donors and recipients may further prevent the misdiagnosis of CIHHV‐6. Human Herpesvirus 6 chromosomal integration (CIHHV‐6) showed a prevalence of 0.9% in Italian AlloSCT and SOT patients, and might represent a diagnostic pitfall unless HHV‐6 viral loads on different specimens are compared.