TY - JOUR
T1 - Chromosomally integrated human herpesvirus 6
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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U2 - 10.1002/rmv.715
DO - 10.1002/rmv.715
M3 - Review article
C2 - 22052666
AN - SCOPUS:84860306214
SN - 1052-9276
VL - 22
SP - 144
EP - 155
JO - Reviews in Medical Virology
JF - Reviews in Medical Virology
IS - 3
ER -
