Transmission of integrated human herpesvirus 6 through stem cell transplantation: implications for laboratory diagnosis.
We identified a stem cell donor with chromosomally integrated human herpesvirus (HHV)-6 and monitored the recipient for HHV-6 after transplantation. The appearance and subsequent increase in HHV-6 load paralleled engraftment and an increase in white blood cell count. Fluorescent in situ hybridization analysis showed integrated HHV-6 on chromosome band 17p13.3 in the donor and in the recipient after transplantation but not in the recipient before transplantation. The increase in viral load due to the genetic transmission of integrated HHV-6 could have been misinterpreted as substantial active infection and, thus, led to the administration of toxic antiviral therapy. We suggest that the confounding influence of integration be considered in laboratory investigations associating HHV-6 with disease.
Clark
Duncan A
DA
Centre for Virology, Division of Infection and Immunity, Royal Free and University College Medical School, London, United Kingdom. duncan.clark@bartsandthelondon.nhs.uk
Nacheva
Elisabeth P
EP
Leong
Hoe Nam
HN
Brazma
Diana
D
Li
Ying Ting
YT
Tsao
Edward H F
EH
Buyck
Hubertus C E
HC
Atkinson
Claire E
CE
Lawson
Heather M
HM
Potter
Michael N
MN
Griffiths
Paul D
PD
D000328:Adult; D002877:Chromosomes, Human / Q000821:virology; D004279:DNA, Viral / Q000032:analysis / Q000235:genetics; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D015654:Herpesvirus 6, Human / Q000235:genetics* / Q000302:isolation & purification*; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D015470:Leukemia, Myeloid, Acute / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011533:Proviruses / Q000235:genetics*; D019349:Roseolovirus Infections / Q000635:transmission* / Q000821:virology; D019562:Viral Load; D016662:Virus Integration
D004279:DNA, Viral