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 & 6 others Joshua C. Pritchett, Sylvie Rogez, Edward Seto, Katherine N. Ward, Tetsushi Yoshikawa, Raymund R. Razonable

Research output: Contribution to journalReview article

176 Citations (Scopus)

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 languageEnglish
Pages (from-to)144-155
Number of pages12
JournalReviews in Medical Virology
Volume22
Issue number3
DOIs
Publication statusPublished - 01-05-2012

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Human Herpesvirus 6
DNA
Genome
Immune Tolerance
Graft Rejection
Viral Proteins
Bacterial Infections
Germ Cells
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Virology
  • Infectious Diseases

Cite this

Pellett, P. E., Ablashi, D. V., Ambros, P. F., Agut, H., Caserta, M. T., Descamps, V., ... 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, Philip E. ; Ablashi, Dharam V. ; Ambros, Peter F. ; Agut, Henri ; Caserta, Mary T. ; Descamps, Vincent ; Flamand, Louis ; Gautheret-Dejean, Agnès ; Hall, Caroline B. ; Kamble, Rammurti T. ; Kuehl, Uwe ; Lassner, Dirk ; Lautenschlager, Irmeli ; Loomis, Kristin S. ; Luppi, Mario ; Lusso, Paolo ; Medveczky, Peter G. ; Montoya, Jose G. ; Mori, Yasuko ; Ogata, Masao ; Pritchett, Joshua C. ; Rogez, Sylvie ; Seto, Edward ; Ward, Katherine N. ; Yoshikawa, Tetsushi ; Razonable, Raymund R. / Chromosomally integrated human herpesvirus 6 : Questions and answers. In: Reviews in Medical Virology. 2012 ; Vol. 22, No. 3. pp. 144-155.
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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.",
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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

Chromosomally integrated human herpesvirus 6 : Questions and answers. / Pellett, Philip E.; Ablashi, Dharam V.; Ambros, Peter F.; Agut, Henri; Caserta, Mary T.; Descamps, Vincent; Flamand, Louis; Gautheret-Dejean, Agnès; Hall, Caroline B.; Kamble, Rammurti T.; Kuehl, Uwe; Lassner, Dirk; Lautenschlager, Irmeli; Loomis, Kristin S.; Luppi, Mario; Lusso, Paolo; Medveczky, Peter G.; Montoya, Jose G.; Mori, Yasuko; Ogata, Masao; Pritchett, Joshua C.; Rogez, Sylvie; Seto, Edward; Ward, Katherine N.; Yoshikawa, Tetsushi; Razonable, Raymund R.

In: Reviews in Medical Virology, Vol. 22, No. 3, 01.05.2012, p. 144-155.

Research output: Contribution to journalReview article

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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 - 2012/5/1

Y1 - 2012/5/1

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.

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Pellett PE, Ablashi DV, Ambros PF, Agut H, Caserta MT, Descamps V et al. Chromosomally integrated human herpesvirus 6: Questions and answers. Reviews in Medical Virology. 2012 May 1;22(3):144-155. https://doi.org/10.1002/rmv.715