Transmission of chromosomally integrated human herpesvirsus 6 (HHV-6) variant A from a parent to children leading to misdiagnosis of active HHV-6 infection.
Only a handful of cases of chromosomally integrated human herpesvirus 6 (CI-HHV-6) have been reported, suggesting that this phenomenon is rare. We here present a familial case of HHV-6 variant A (HHV-6A) transmission through a generation, which was identified in the setting of allogeneic hematopoietic stem cell transplantation (HSCT). A 31-year-old man with myelodysplastic syndrome underwent allogeneic HSCT from a human leukocyte antigen-identical sibling, and was found to be continuously yielding high copy numbers of HHV-6A DNA in plasma evaluated by real-time polymerase chain reaction (PCR). Antiviral therapy with ganciclovir or foscarnet failed to decrease the copy numbers. HHV-6A DNA was detected in the patient's buccal mucosa and hair follicles, and was also detected in the plasma, whole blood, and buccal mucosa of the patient's father and 2 siblings, but not in his mother. The sequences of HHV-6A DNA isolated from all family members were identical. Since monitoring of HHV-6 by PCR has been widely introduced to the field of HSCT, transplant physicians should be aware of such an alternative form of HHV-6 transmission, particularly when HHV-6A is detected.
Mori
T
T
Department of Medicine, Keio University School of Medicine, Tokyo, Japan. tmori@sc.itc.keio.ac.jp
Tanaka-Taya
K
K
Satoh
H
H
Aisa
Y
Y
Yamazaki
R
R
Kato
J
J
Ikeda
Y
Y
Okamoto
S
S
D000328:Adult; D002877:Chromosomes, Human / Q000821:virology*; D004279:DNA, Viral / Q000097:blood / Q000235:genetics; D003951:Diagnostic Errors; D014644:Genetic Variation; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D015654:Herpesvirus 6, Human / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D010290:Parents; D016133:Polymerase Chain Reaction / Q000379:methods; D019349:Roseolovirus Infections / Q000175:diagnosis / Q000635:transmission / Q000821:virology; D035781:Siblings; D014184:Transplantation, Homologous / Q000009:adverse effects; D016662:Virus Integration
D004279:DNA, Viral