TY - JOUR
T1 - Donor-to-recipient transmission and reactivation in a kidney transplant recipient of an inherited chromosomally integrated HHV-6A
T2 - Evidence and outcomes
AU - Petit, Vivien
AU - Bonnafous, Pascale
AU - Fages, Victor
AU - Gautheret-Dejean, Agnès
AU - Engelmann, Ilka
AU - Baras, Agathe
AU - Hober, Didier
AU - Gérard, Romain
AU - Gibier, Jean-Baptiste
AU - Leteurtre, Emmanuelle
AU - Glowacki, François
AU - Moulonguet, Florence
AU - Decaestecker, Antoine
AU - Provôt, François
AU - Chamley, Paul
AU - Faure, Emmanuel
AU - Prusty, Bhupesh K
AU - Maanaoui, Mehdi
AU - Hazzan, Marc
N1 - © 2020 The American Society of Transplantation and the American Society of Transplant Surgeons.
PY - 2020/12
Y1 - 2020/12
N2 - Human herpesvirus (HHV)-6A can be inherited and chromosomally integrated (iciHHV-6A), and donor-to-recipient transmission has been reported in solid organ transplant. However, when HHV-6A reactivation happens after transplant, the source of HHV-6A is often not evident and its pathogenicity remains unclear. Here, we present an exhaustive case of donor-to-recipient transmission and reactivation of iciHHV-6A through kidney transplant. The absence of HHV-6A genome from the nails of the recipient excluded a recipient-related iciHHV-6A. Viral loads > 7 log10 copies/106 cells in donor blood samples and similarities of U38, U39, U69, and U100 viral genes between donor, recipient, and previously published iciHHV-6A strains are proof of donor-related transmission. Detection of noncoding HHV-6 snc-RNA14 using fluorescence in situ hybridization analysis and immunofluorescence staining of HHV-6A gp82/gp105 late proteins on kidney biopsies showed evidence of reactivation in the transplanted kidney. Because HHV-6A reactivation can be life threatening in immunocompromised patients, we provide several tools to help during the complete screening and diagnosis.
AB - Human herpesvirus (HHV)-6A can be inherited and chromosomally integrated (iciHHV-6A), and donor-to-recipient transmission has been reported in solid organ transplant. However, when HHV-6A reactivation happens after transplant, the source of HHV-6A is often not evident and its pathogenicity remains unclear. Here, we present an exhaustive case of donor-to-recipient transmission and reactivation of iciHHV-6A through kidney transplant. The absence of HHV-6A genome from the nails of the recipient excluded a recipient-related iciHHV-6A. Viral loads > 7 log10 copies/106 cells in donor blood samples and similarities of U38, U39, U69, and U100 viral genes between donor, recipient, and previously published iciHHV-6A strains are proof of donor-related transmission. Detection of noncoding HHV-6 snc-RNA14 using fluorescence in situ hybridization analysis and immunofluorescence staining of HHV-6A gp82/gp105 late proteins on kidney biopsies showed evidence of reactivation in the transplanted kidney. Because HHV-6A reactivation can be life threatening in immunocompromised patients, we provide several tools to help during the complete screening and diagnosis.
KW - DNA, Viral
KW - Herpesvirus 6, Human/genetics
KW - Humans
KW - In Situ Hybridization, Fluorescence
KW - Kidney Transplantation/adverse effects
KW - Transplant Recipients
KW - Virus Integration
UR - https://www-scopus-com.db.rsu.lv/record/display.uri?eid=2-s2.0-85087299024&origin=resultslist&sort=plf-f&src=s&sid=0613949c685dc0009f90103e4fc21067&sot=b&sdt=b&s=TITLE%28Donor-to-recipient+transmission+and+reactivation+in+a+kidney+transplant+recipient+of+an+inherited+chromosomally+integrated+HHV-6A%29&sl=136&sessionSearchId=0613949c685dc0009f90103e4fc21067&relpos=0
U2 - 10.1111/ajt.16067
DO - 10.1111/ajt.16067
M3 - Article
C2 - 32428994
SN - 1600-6135
VL - 20
SP - 3667
EP - 3672
JO - American Journal of Transplantation
JF - American Journal of Transplantation
IS - 12
ER -