人类疱疹病毒 6 与移植受者：诊断和治疗策略的最新进展。
Human herpesvirus 6 in transplant recipients: an update on diagnostic and treatment strategies.
机构信息
Vaccine and Infectious Disease Division.
Clinical Research Division, Fred Hutchinson Cancer Research Center.
出版信息
Curr Opin Infect Dis. 2019 Dec;32(6):584-590. doi: 10.1097/QCO.0000000000000592.
Abstract
PURPOSE OF REVIEW
The current review article focuses on recent advances in the approach to the diagnosis and treatment of human herpesvirus 6B (HHV-6B) in hematopoietic cell and solid organ transplant recipients.
RECENT FINDINGS
Over the past few years, key studies have broadened our understanding of best practices for the prevention and treatment of HHV-6B encephalitis after transplantation. Moreover, important data have been reported that support a potential role of HHV-6B reactivation in the development of acute graft-versus-host disease and lower respiratory tract disease in transplant recipients. Finally, increasing recognition of inherited chromosomally integrated HHV-6 (iciHHV-6) and an expanding array of diagnostic tools have increased our understanding of the potential for complications related to viral reactivation originating from iciHHV-6 in donors or recipients.
SUMMARY
Recent advances in diagnostic tools, disease associations, and potential treatments for HHV-6B present abundant opportunities for improving our understanding and management of this complex virus in transplant recipients.
摘要
目的综述
本文重点介绍造血细胞和实体器官移植受者中人类疱疹病毒 6B（HHV-6B）的诊断和治疗方法的最新进展。
最近的发现
在过去的几年中，一些重要研究拓宽了我们对预防和治疗移植后 HHV-6B 脑炎的最佳方法的理解。此外，已有重要数据表明 HHV-6B 再激活可能与移植受者急性移植物抗宿主病和下呼吸道疾病的发生有关。最后，人们越来越认识到染色体整合的人类疱疹病毒 6（iciHHV-6）和不断扩展的诊断工具阵列，这增加了我们对供体或受体内源性病毒再激活相关并发症的理解。
总结
HHV-6B 的诊断工具、疾病相关性和潜在治疗方法的最新进展为改善我们对移植受者中这种复杂病毒的理解和管理提供了丰富的机会。
相似文献
1
Human herpesvirus 6 in transplant recipients: an update on diagnostic and treatment strategies.人类疱疹病毒 6 与移植受者：诊断和治疗策略的最新进展。
Curr Opin Infect Dis. 2019 Dec;32(6):584-590. doi: 10.1097/QCO.0000000000000592.
2
Detection of Human Herpesvirus 6B (HHV-6B) Reactivation in Hematopoietic Cell Transplant Recipients with Inherited Chromosomally Integrated HHV-6A by Droplet Digital PCR.通过液滴数字PCR检测遗传性染色体整合HHV-6A的造血细胞移植受者中人类疱疹病毒6B（HHV-6B）的再激活情况。
J Clin Microbiol. 2016 May;54(5):1223-7. doi: 10.1128/JCM.03275-15. Epub 2016 Feb 17.
3
Guidelines from the 2017 European Conference on Infections in Leukaemia for management of HHV-6 infection in patients with hematologic malignancies and after hematopoietic stem cell transplantation.2017 年欧洲白血病感染会议关于血液系统恶性肿瘤患者和造血干细胞移植后人类疱疹病毒 6 感染管理的指南。
Haematologica. 2019 Nov;104(11):2155-2163. doi: 10.3324/haematol.2019.223073. Epub 2019 Aug 29.
4
Human Herpesvirus 6B in the Transplant Recipient: When to Worry, When to Act.人类疱疹病毒 6B 在移植受者中的情况：何时需要担忧，何时需要采取行动。
J Pediatric Infect Dis Soc. 2018 Dec 26;7(suppl_2):S75-S78. doi: 10.1093/jpids/piy111.
5
Human herpesvirus-6 infections in kidney, liver, lung, and heart transplantation: review.人类疱疹病毒 6 感染与肾、肝、肺和心脏移植：综述。
Transpl Int. 2012 May;25(5):493-502. doi: 10.1111/j.1432-2277.2012.01443.x. Epub 2012 Feb 23.
6
Human Herpes Virus-6 (HHV-6) Reactivation after Hematopoietic Cell Transplant and Chimeric Antigen Receptor (CAR)- T Cell Therapy: A Shifting Landscape.造血细胞移植和嵌合抗原受体（CAR）-T细胞治疗后人类疱疹病毒6型（HHV-6）再激活：不断变化的局面
Viruses. 2024 Mar 24;16(4):498. doi: 10.3390/v16040498.
7
Late-phase human herpesvirus 6B reactivation in hematopoietic stem cell transplant recipients.造血干细胞移植受者中人类疱疹病毒6B的晚期再激活
Transpl Infect Dis. 2018 Aug;20(4):e12916. doi: 10.1111/tid.12916. Epub 2018 Jun 13.
8
[Human herpesvirus type 6 and type 7 in transplant recipients].移植受者中的人类疱疹病毒6型和7型
Enferm Infecc Microbiol Clin. 2003 Oct;21(8):424-32. doi: 10.1016/s0213-005x(03)72980-2.
9
Chromosomally integrated human herpesvirus-6 in transplant recipients.移植受者中染色体整合的人疱疹病毒6型
Transpl Infect Dis. 2012 Aug;14(4):346-54. doi: 10.1111/j.1399-3062.2011.00715.x. Epub 2012 Feb 9.
10
RNA Sequencing of the Human Herpesvirus 6B Transcriptome To Identify Targets for Clinical Assays Distinguishing between Latent and Active Infections.人类疱疹病毒 6B 转录组的 RNA 测序，以鉴定用于区分潜伏和活跃感染的临床检测的靶标。
J Virol. 2019 Jan 17;93(3). doi: 10.1128/JVI.01419-18. Print 2019 Feb 1.
引用本文的文献
1
Clinical characteristic and outcome of HHV-6 encephalitis after allogeneic hematopoietic cell transplantation: A study of Infectious Disease Working Party of EBMT.异基因造血细胞移植后HHV-6脑炎的临床特征与转归：欧洲血液与骨髓移植组传染病工作组的一项研究
Bone Marrow Transplant. 2025 Jun 3. doi: 10.1038/s41409-025-02638-7.
2
Post-Transplant Cyclophosphamide-Based Prophylaxis and Its Impact on Infectious Complications and Immune Reconstitution According to Donor Type.基于移植后环磷酰胺的预防措施及其对根据供体类型的感染并发症和免疫重建的影响。
Cancers (Basel). 2025 Mar 26;17(7):1109. doi: 10.3390/cancers17071109.
3
A Systematic Literature Review to Determine Gaps in Diagnosing Suspected Infection in Solid Organ Transplant Recipients.一项确定实体器官移植受者疑似感染诊断差距的系统文献综述。
Open Forum Infect Dis. 2025 Jan 8;12(1):ofaf001. doi: 10.1093/ofid/ofaf001. eCollection 2025 Jan.
4
Pneumonia in Transplant Recipients: A Comprehensive Review of Diagnosis and Management.移植受者的肺炎：诊断与管理的全面综述
Cureus. 2024 Nov 14;16(11):e73669. doi: 10.7759/cureus.73669. eCollection 2024 Nov.
5
Identifying CNS infections in transplantation and immunomodulatory therapy.识别移植及免疫调节治疗中的中枢神经系统感染
Ther Adv Infect Dis. 2024 Nov 9;11:20499361241298456. doi: 10.1177/20499361241298456. eCollection 2024 Jan-Dec.
6
Symptomatic central nervous system tuberculosis and human herpesvirus-6 coinfection with associated hydrocephalus managed with endoscopic third ventriculostomy: A case report and review of human herpesvirus-6 neuropathology.症状性中枢神经系统结核与人类疱疹病毒6型合并感染伴脑积水行内镜下第三脑室造瘘术治疗：1例报告及人类疱疹病毒6型神经病理学综述
Surg Neurol Int. 2024 Aug 16;15:287. doi: 10.25259/SNI_355_2024. eCollection 2024.
7
Reactivation of a Transplant Recipient's Inherited Human Herpesvirus 6 and Implications to the Graft.移植受者遗传性人疱疹病毒6的再激活及其对移植物的影响。
J Infect Dis. 2025 Feb 20;231(2):e267-e276. doi: 10.1093/infdis/jiae268.
8
Human Herpes Virus-6 (HHV-6) Reactivation after Hematopoietic Cell Transplant and Chimeric Antigen Receptor (CAR)- T Cell Therapy: A Shifting Landscape.造血细胞移植和嵌合抗原受体（CAR）-T细胞治疗后人类疱疹病毒6型（HHV-6）再激活：不断变化的局面
Viruses. 2024 Mar 24;16(4):498. doi: 10.3390/v16040498.
9
Case report: Acute HHV6B encephalitis/myelitis post CAR-T cell therapy in patients with relapsed/refractory aggressive B-cell lymphoma.病例报告：复发/难治性侵袭性B细胞淋巴瘤患者接受CAR-T细胞治疗后发生急性人疱疹病毒6B型脑炎/脊髓炎
Front Neurol. 2024 Feb 29;15:1334000. doi: 10.3389/fneur.2024.1334000. eCollection 2024.
10
Viral meningoencephalitis in pediatric solid organ or hematopoietic cell transplant recipients: a diagnostic and therapeutic approach.小儿实体器官或造血细胞移植受者的病毒性脑膜脑炎：诊断与治疗方法
Front Pediatr. 2024 Feb 12;12:1259088. doi: 10.3389/fped.2024.1259088. eCollection 2024.
本文引用的文献
1
Guidelines from the 2017 European Conference on Infections in Leukaemia for management of HHV-6 infection in patients with hematologic malignancies and after hematopoietic stem cell transplantation.2017 年欧洲白血病感染会议关于血液系统恶性肿瘤患者和造血干细胞移植后人类疱疹病毒 6 感染管理的指南。
Haematologica. 2019 Nov;104(11):2155-2163. doi: 10.3324/haematol.2019.223073. Epub 2019 Aug 29.
2
Human Herpesvirus 6B and Lower Respiratory Tract Disease After Hematopoietic Cell Transplantation.人类疱疹病毒 6B 与造血细胞移植后下呼吸道疾病。
J Clin Oncol. 2019 Oct 10;37(29):2670-2681. doi: 10.1200/JCO.19.00908. Epub 2019 Aug 26.
3
Human herpesvirus 6 infection after autologous stem cell transplantation: A multicenter prospective study in adult patients.自体造血干细胞移植后人类疱疹病毒 6 感染：一项针对成年患者的多中心前瞻性研究。
J Infect. 2019 Jul;79(1):36-42. doi: 10.1016/j.jinf.2019.05.001. Epub 2019 May 7.
4
Human herpesvirus 6, 7, and 8 in solid organ transplantation: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice.人类疱疹病毒 6、7 和 8 与实体器官移植：美国移植感染病学会实践社区指南。
Clin Transplant. 2019 Sep;33(9):e13518. doi: 10.1111/ctr.13518. Epub 2019 Apr 4.
5
First-Onset Herpesviral Infection and Lung Injury in Allogeneic Hematopoietic Cell Transplantation.异基因造血细胞移植后初次单纯疱疹病毒感染与肺部损伤
Am J Respir Crit Care Med. 2019 Jul 1;200(1):63-74. doi: 10.1164/rccm.201809-1635OC.
6
Virus detection in the cerebrospinal fluid of hematopoietic stem cell transplant recipients is associated with poor patient outcomes: a CIBMTR contemporary longitudinal study.造血干细胞移植受者脑脊液中病毒检测与患者不良预后相关：CIBMTR 当代纵向研究。
Bone Marrow Transplant. 2019 Aug;54(8):1354-1360. doi: 10.1038/s41409-019-0457-9. Epub 2019 Jan 29.
7
In vitro comparison of currently available and investigational antiviral agents against pathogenic human double-stranded DNA viruses: A systematic literature review.目前可用的和研究性抗病毒药物对致病性人类双链 DNA 病毒的体外比较：系统文献回顾。
Antiviral Res. 2019 Mar;163:50-58. doi: 10.1016/j.antiviral.2019.01.008. Epub 2019 Jan 21.
8
RNA Sequencing of the Human Herpesvirus 6B Transcriptome To Identify Targets for Clinical Assays Distinguishing between Latent and Active Infections.人类疱疹病毒 6B 转录组的 RNA 测序，以鉴定用于区分潜伏和活跃感染的临床检测的靶标。
J Virol. 2019 Jan 17;93(3). doi: 10.1128/JVI.01419-18. Print 2019 Feb 1.
9
A Randomized, Double-Blind, Placebo-Controlled Phase 3 Trial of Oral Brincidofovir for Cytomegalovirus Prophylaxis in Allogeneic Hematopoietic Cell Transplantation.一项随机、双盲、安慰剂对照的 3 期临床试验，评估口服溴昔洛韦在异基因造血细胞移植中用于巨细胞病毒预防的效果。
Biol Blood Marrow Transplant. 2019 Feb;25(2):369-381. doi: 10.1016/j.bbmt.2018.09.038. Epub 2018 Oct 4.
10
HHV-6 encoded small non-coding RNAs define an intermediate and early stage in viral reactivation.人疱疹病毒6型编码的小非编码RNA定义了病毒再激活的一个中期和早期阶段。
NPJ Genom Med. 2018 Sep 5;3:25. doi: 10.1038/s41525-018-0064-5. eCollection 2018.
Zotero 插件