Sorbonne Université, Faculté de médecine, INSERM, CIMI-Paris U1135, Equipe PVI, F-75013 Paris, France.
Morphogenèse et Antigénicité du VIH et des Virus des Hépatites Tours, Inserm U1259, Université de Tours, Tours, France.
Am J Transplant. 2018 Jun;18(6):1548-1551. doi: 10.1111/ajt.14657. Epub 2018 Jan 27.
HHV-6A and HHV-6B are found as inherited and chromosomally integrated forms (iciHHV-6A and -6B) into all germinal and somatic cells and vertically transmitted in a Mendelian manner in about 1% of the population. They were occasionally shown to be horizontally transmitted through hematopoietic stem cell transplantation. Here, we present a clinical case of horizontal transmission of iciHHV-6A from donor to recipient through liver transplantation. Molecular analysis performed on three viral genes (7.2 kb) in the recipient and donor samples supports transmission of iciHHV-6A from the graft. Transmission was followed by reactivation, with high viral loads in several compartments. The infection was uncontrollable, leading to severe disease and death, despite antiviral treatments and the absence of resistance mutations. This case highlights the fact that physicians should be aware of the possible horizontal transmission of iciHHV-6 and its consequences in case of reactivation in immunocompromised patients.
HHV-6A 和 HHV-6B 以遗传和染色体整合形式（iciHHV-6A 和 -6B）存在于所有生殖细胞和体细胞中，并以孟德尔方式在约 1%的人群中垂直传播。它们偶尔通过造血干细胞移植水平传播。在这里，我们报告了一例通过肝移植从供体到受体的 iciHHV-6A 水平传播的临床病例。对受者和供者样本中三个病毒基因（7.2kb）进行的分子分析支持来自移植物的 iciHHV-6A 传播。传播后病毒再激活，多个部位的病毒载量很高。尽管进行了抗病毒治疗且不存在耐药突变，但感染仍无法控制，导致病情严重并死亡。该病例强调了这样一个事实，即医生应意识到在免疫功能低下患者中病毒再激活时，可能会发生 iciHHV-6 的水平传播及其后果。
