Prevalence of Human Herpesvirus-6 Chromosomal Integration (CIHHV-6) in Italian Solid Organ and Allogeneic Stem Cell Transplant Patients
Prevalence of Human Herpesvirus-6 Chromosomal Integration (CIHHV-6) in Italian Solid Organ and Allogeneic Stem Cell Transplant Patients
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DOI：
10.1111/j.1600-6143.2009.02685.x
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发表时间：
2009-07-01
影响因子：
8.8
通讯作者：
Luppi, M.
中科院分区：
文献类型：
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作者：
Potenza, L.;Barozzi, P.;Luppi, M.
人类疱疹病毒-6（HHV-6）染色体整合（CIHHV-6）的独特现象可能导致移植环境中的临床缺陷，被误解为活动性感染并导致不必要的和潜在有害的治疗。我们调查了CIHHV-6在205例连续实体器官（SO）和异基因干细胞移植（alloSCT）意大利患者中的患病率。实时荧光定量PCR检测135例实体器官移植（SOT）患者中52例（38.5%）血浆HHV-6 DNA阳性，70例alloSCT患者中16例（22.8%）血浆HHV-6 DNA阳性。7例SOT和3例alloSCT患者出现HHV-6相关疾病，需要抗病毒药物治疗。确定了另外两名患者（0.9%），表现出高HHV-6载量。毛囊上HHV-6的定量揭示了整合状态，允许停用抗病毒药物。在开始特异性治疗之前，应通过比较不同体液和组织上的HHV-6载量，排除HHV-6病毒血症移植患者中的CIHHV-6。移植前对供体和受体进行筛查可能会进一步防止CIHHV-6的误诊。
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.