Mineri Rossana, Mariotti Jacopo, Sarina Barbara, Morabito Lucio, Crocchiolo Roberto, Bramanti Stefania, Sarno Tiziana, Tordato Federica, Carlo-Stella Carmelo, Santoro Armando, Castagna Luca
Molecular Biology Section, Clinical Investigation Laboratory, Humanitas Clinical and Research Center, Via Manzoni 56, Rozzano 20089, Italy.
Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center, Via Manzoni 56, Rozzano 20089, Italy.
Mediterr J Hematol Infect Dis. 2018 Feb 15;10(1):e2018013. doi: 10.4084/MJHID.2018.013. eCollection 2018.
The monitoring of Human Herpesvirus 6 (HHV-6) after allogeneic stem cell transplantation has proven to be useful in preventing life-threatening complications; however, the pathogenic role of HHV-6 after autologous transplantation is not well-characterized, although viral reactivation might be responsible for significant complications even after this type of transplant. Here we report, for the first time to our knowledge, the case of a patient with chromosomally integrated HHV-6 (ciHHV-6), presenting with high titers of HHV-6 DNA copies after autologous transplantation, mimicking HHV-6 reactivation. The presence of viral DNA in the follicle bulb confirmed the ciHHV-6 and allowed for the discontinuation of the antiviral treatment. Due to the increasing awareness of HHV-6 potential pathogenicity and the fact that ciHHV-6 is expected in 1-2% of the population, such a case might be helpful in recognizing ci HHV-6, thus avoiding unnecessary and potentially toxic antiviral therapy once the viral genomic integration is confirmed.
同种异体干细胞移植后对人疱疹病毒6型(HHV-6)的监测已被证明有助于预防危及生命的并发症;然而,尽管病毒再激活可能导致自体移植后出现严重并发症,但HHV-6在自体移植后的致病作用尚不明确。据我们所知,本文首次报道了一例染色体整合型HHV-6(ciHHV-6)患者,自体移植后出现高滴度的HHV-6 DNA拷贝数,类似HHV-6再激活。毛囊球中病毒DNA的存在证实了ciHHV-6,从而可以停止抗病毒治疗。鉴于对HHV-6潜在致病性的认识不断提高,且预计1%-2%的人群中存在ciHHV-6,这样的病例可能有助于识别ciHHV-6,从而在确认病毒基因组整合后避免不必要的、可能有毒的抗病毒治疗。