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Transplant Cell Ther 2021 Jun 7. Epub 2021 Jun 7.

Fred Hutchinson Cancer Research Center, Vaccine and Infectious Disease Division, Seattle, WA, USA; Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, USA. Electronic address:

Background: Reactivation of human herpesvirus 6 (HHV-6) after allogeneic hematopoietic cell transplant (HCT) is associated with neurologic complications, but the impact of donor and/or recipient inherited chromosomally integrated HHV-6 (iciHHV-6) on post-HCT central nervous system (CNS) symptoms, diagnostic and therapeutic interventions is not well understood.

Objective: The aims of the study were 1) to compare the cumulative incidence of CNS symptoms in the first 100 days following allogeneic HCT among patients with donor and/or recipient iciHHV-6 (iciHHV-6) to that of patients with neither donor nor recipient iciHHV-6 (iciHHV-6) and 2) to assess the role of HHV-6 detection in driving potentially unnecessary interventions in iciHHV-6 patients.

Study Design: We performed a retrospective matched cohort study of 87 iciHHV-6 and 174 iciHHV-6 allogeneic HCT recipients. Read More

Ther Adv Infect Dis 2021 Jan-Dec;8:20499361211018027. Epub 2021 May 24.

Division of Hematology and Oncology, Department of Medicine, UMass Memorial Medical Center, 55 Lake Avenue North, Worcester, MA, 01655, USA.

Human cytomegalovirus and Epstein-Barr virus have been recognized as potential drivers of morbidity and mortality of patients undergoing allogeneic stem cell transplantation for years. Specific protocols for monitoring, prophylaxis and pre-emptive therapy are in place in many transplant settings. In this review, we focus on the next three most frequent viruses, human herpesvirus-6, BK virus and adenovirus, causing reactivation and/or viremia after allogeneic transplant, which are increasingly detected in patients in the post-transplant period owing to emerging techniques of molecular biology, recipients' characteristics, treatment modalities used for conditioning and factors related donors or stem cell source. Read More

Medicine (Baltimore) 2021 Jun;100(22):e25468

Division of Rehabilitation Medicine, University of Fukui Hospital.

Rationale: Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is a condition characterized by biphasic convulsions and disturbance of consciousness. In Japan, the most common pediatric cases of acute encephalopathy are associated with infection. AESD usually occurs in early childhood, with the characteristic magnetic resonance imaging (MRI) appearance called "bright tree appearance. Read More

Arch Pathol Lab Med 2021 Jun 4. Epub 2021 Jun 4.

From the Division of Critical Care and Hospitalist Neurology, Department of Neurology (Waldrop, Radmard, Thakur), Columbia University Irving Medical Center, New York, New York.

Context.—: The FilmArray Meningitis/Encephalitis (ME) panel is the first US Food and Drug Administration-cleared multiplex polymerase chain reaction panel for the detection of central nervous system infections. While the assay's performance characteristics have been described, the real-world significance of positive results has not been fully characterized. Read More

J Infect Chemother 2021 May 31. Epub 2021 May 31.

Department of Hematology, Tokyo Medical University, Tokyo, Japan.

Human herpesvirus-6 (HHV-6) reactivation is an important complication in patients receiving umbilical cord blood transplantation (CBT). Chromosomally integrated human herpesvirus-6 (ciHHV-6) is a condition in which the complete HHV-6 genome is integrated into the host germline genome and is transmitted in a Mendelian manner. The influence of ciHHV-6 in recipients or donors in cases of CBT is unknown. Read More

Cancers (Basel) 2021 May 27;13(11). Epub 2021 May 27.

Department of Tumor Pathology, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan.

Cancer arises from the accumulation of genetic and epigenetic alterations. Even in the era of precision oncology, carcinogens contributing to neoplastic process are still an important focus of research. Comprehensive genomic analyses have revealed various combinations of base substitutions, referred to as the mutational signatures, in cancer. Read More

J Med Case Rep 2021 May 25;15(1):300. Epub 2021 May 25.

Department of Neonatal Medicine and Pediatric Intensive Care, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, 371 Avenue du Doyen Gaston Giraud, 34295, Montpellier Cedex 5, France.

Background: Cardiac and neurological involvement in hemolytic uremic syndrome are life-threatening complications. The most frequent complications of cardiac involvement in hemolytic uremic syndrome are myocarditis and cardiac dysfunction due to fluid overload. Pericarditis remains very rare in hemolytic uremic syndrome. Read More

Arch Argent Pediatr 2021 06;119(3):e247-e251

Servicio de Anatomía Patológica, Hospital Clínico San Borja Arriarán, Santiago, Chile.

Drug reaction with eosinophilia and systemic symptoms syndrome associated with human herpesvirus 6. A pediatric case treated with cyclosporine and corticosteroids elevated C-reactive protein, and abnormal liver tests. The skin biopsy was compatible with an adverse drug reaction. Read More

Transplant Cell Ther 2021 May 28;27(5):437.e1-437.e9. Epub 2021 Jan 28.

Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan.

Post-transplantation acute limbic encephalitis (PALE) is a rare, severe inflammatory disorder in the bilateral limbic system, including the hippocampus. To date, only a few studies have reported details, including risk factors for PALE; however, further clinical evidence of PALE, especially in cerebrospinal fluid human herpesvirus 6-negative cases, is warranted. In addition, data are sparse regarding the risk factors for calcineurin inhibitor (CNI)-induced encephalopathy (CNIE) following allogeneic hematopoietic cell transplantation (allo-HCT) in adults. Read More

Cells 2021 Apr 29;10(5). Epub 2021 Apr 29.

Department of Chemical, Pharmaceutical and Agricultural Sciences and LTTA, University of Ferrara, 44121 Ferrara, Italy.

Human cytomegalovirus (HCMV) and Human herpesvirus 6 (HHV-6) have been reportedly suggested as triggers of the onset and/or progression of systemic sclerosis (SSc), a severe autoimmune disorder characterized by multi-organ fibrosis. The etiology and pathogenesis of SSc are still largely unknown but virological and immunological observations support a role for these beta-herpesviruses, and we recently observed a direct impact of HCMV and HHV-6 infection on the expression of cell factors associated with fibrosis at the cell level. Since miRNA expression has been found profoundly deregulated at the tissue level, here we aimed to investigate the impact on cell microRNome (miRNome) of HCMV and HHV-6 infection in in vitro infected primary human dermal fibroblasts, which represent one of the main SSc target cells. Read More

Am J Trop Med Hyg 2021 May 3. Epub 2021 May 3.

1Institut Pasteur de Dakar, Unité de Virologie Médicale, Dakar, Sénégal.

Herpesviruses are known to cause a diversity of clinical syndromes, ranging from minor cutaneous lesions to life-threatening illnesses, especially in immunocompromised hosts. Here, we investigate retrospectively the contribution of five human herpesviruses, including herpes simplex virus Cytomegalovirus (CMV), the Epstein-Barr virus (EBV), human herpesvirus 6, and varicella zoster virus (VZV) in serum samples collected from measles suspected patients with at least fever and rash. Sera specimens were first tested for serological evidence of measles and rubella virus infection by ELISA, and DNA extracted from an aliquot of each clinical specimen for molecular detection of human herpes viruses by RT-qPCR. Read More

Emerg Microbes Infect 2021 Dec;10(1):982-993

Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland.

Viral infections are the leading cause of childhood acute febrile illnesses motivating consultation in sub-Saharan Africa. The majority of causal viruses are never identified in low-resource clinical settings as such testing is either not part of routine screening or available diagnostic tools have limited ability to detect new/unexpected viral variants. An in-depth exploration of the blood virome is therefore necessary to clarify the potential viral origin of fever in children. Read More

Viruses 2021 04 13;13(4). Epub 2021 Apr 13.

Institut Pasteur de Guinée, BP 4416 Conakry, Guinea.

The emergence of the Zika virus (ZIKV) mirrors its evolutionary nature and, thus, its ability to grow in diversity or complexity (i.e., related to genome, host response, environment changes, tropism, and pathogenicity), leading to it recently joining the circle of closed congenital pathogens. Read More

J Clin Virol 2021 Jun 16;139:104823. Epub 2021 Apr 16.

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Infectious Diseases Unit, Departement of Internal Medicine, Milan, Italy; Università degli Studi di Milano, Department of Pathophysiology and Transplantation, Milan, Italy. Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico.

PLoS Genet 2021 Apr 26;17(4):e1009324. Epub 2021 Apr 26.

Genome Immunobiology RIKEN Hakubi Research Team, RIKEN Center for Integrative Medical Sciences and RIKEN Cluster for Pioneering Research, Yokohama, Japan.

Acquisition of genetic material from viruses by their hosts can generate inter-host structural genome variation. We developed computational tools enabling us to study virus-derived structural variants (SVs) in population-scale whole genome sequencing (WGS) datasets and applied them to 3,332 humans. Although SVs had already been cataloged in these subjects, we found previously-overlooked virus-derived SVs. Read More

J Med Virol 2021 Apr 14. Epub 2021 Apr 14.

Neonatal Intensive Care Unit, Department of Medical and Surgical Neonatology, "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy.

Infections due to human herpesvirus 6 (HHV-6) are frequent during early childhood. Usually, they have a favorable clinical course. Conversely, HHV-6 congenital infections occur in about 1% of neonates and may present with more severe clinical pictures. Read More

Front Immunol 2021 25;12:648945. Epub 2021 Mar 25.

Department of Obstetrics, Gynecology and Reproductive Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.

Human herpesviruses 6A (HHV-6A) and human herpesvirus 6B (HHV-6B)-collectively, HHV-6A/B-are recently-discovered but ancient human viruses. The vast majority of people acquire one or both viruses, typically very early in life, producing an ineradicable lifelong infection. The viruses have been linked to several neurological, pulmonary and hematological diseases. Read More

J Neurovirol 2021 Apr 8. Epub 2021 Apr 8.

Neuroimmunology Unit, National Institute of Neurology and Neurosurgery of Mexico (NINN), Insurgentes sur 3877, 14269, Mexico City, Mexico.

The frequency of central nervous system infections due to herpesvirus have been studied in various populations; however, studies in Mexican mestizo patients are scant. This paper documents the frequency of herpesvirus encephalitis in Mexican mestizo patients from the National Institute of Neurology and Neurosurgery (NINN) of Mexico. To study the frequency of herpetic viral encephalitis at the NINN in the period from 2004 to 2009. Read More

Transplant Cell Ther 2021 Feb 11;27(2):174.e1-174.e5. Epub 2020 Dec 11.

Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.

The majority of adults are seropositive for human herpesvirus 6 (HHV-6). HHV-6 reactivation can occur after allogeneic hematopoietic stem cell transplantation (HSCT) and lead to life-threatening central nervous system disorders. In this prospective study, we evaluated the relationship between HHV-6 reactivation and anti-HHV-6 IgG antibody levels in recipients of allogeneic HSCT. Read More

BMC Microbiol 2021 Apr 6;21(1):104. Epub 2021 Apr 6.

Department of Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.

Background: Immunosuppression during liver transplantation (LT) enables the prevention and treatment of organ rejection but poses a risk for severe infectious diseases. Immune modulation and antimicrobials affect the plasma microbiome. Thus, determining the impact of immunosuppression on the microbiome may be important to understand immunocompetence, elucidate the source of infection, and predict the risk of infection in LT recipients. Read More

Transplant Cell Ther 2021 Mar 11. Epub 2021 Mar 11.

Laboratory of Translational Immunology, Humanitas Clinical and Research Center - IRCCS, Milan, Italy.

Allogeneic stem cell transplantation from haploidentical donor using post-transplantation cyclophosphamide has been used to cure hematological diseases. Because of slow immunological reconstitution, there is an increased incidence of viral infection. The aim of our study was to prospectively evaluate the efficacy and the feasibility of a CD45RA+ depleted donor lymphocytes infusion (DLI) in terms of reduction of viral infection early after haploidentical transplantation. Read More

Transplant Cell Ther 2021 May 25;27(5):439-440. Epub 2021 Feb 25.

Division of Hematology, Oncology and Cellular Therapy, Rush University, Chicago, Illinois. Electronic address:

Cureus 2021 Feb 22;13(2):e13496. Epub 2021 Feb 22.

General Internal Medicine, Bronx Care Health System, Bronx, USA.

DRESS syndrome (Drug Rash with Eosinophilia and Systemic Symptoms) is a severe delayed type IV hypersensitivity drug reaction by T helper cell 2 (Th2) and Interleukin 5 (IL-5) resulting in activation of eosinophils. It is mostly reported with antiepileptic drugs (AEDs), antibiotics, and allopurinol. Here, we present the second case of myocarditis secondary to DRESS syndrome caused by amoxicillin. Read More

Ann Hematol 2021 Mar 26. Epub 2021 Mar 26.

Department of Medicine, Professorial Block, Queen Mary Hospital, Pokfulam Road, Hong Kong, China.

BMJ Case Rep 2021 Mar 24;14(3). Epub 2021 Mar 24.

Division of Infectious Diseases, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon

Human herpes virus-6 (HHV-6) infection is a common infection in the paediatric population and is increasingly reported in immunosuppressed adult patients. It has been reported as the causative agent of disease in few case reports in immunocompetent adults. We report herein an unusual case of HHV-6-associated viraemia, pneumonitis and meningitis in a patient who presented with dyspnoea, hypoxia, dry cough and headache. Read More

Transfusion 2021 May 13;61(5):1505-1517. Epub 2021 Mar 13.

Institute for Health Research (IdiPAZ), La Paz University Hospital, Madrid, Spain.

Background: Naïve T-cell-depleted grafts have been employed as an ex vivo T-cell depletion (TCD) platform to prevent graft-versus-host disease (GvHD) and improve immune reconstitution by providing rapid donor memory T-cell reconstitution after allogenic hematopoietic stem cell transplantation (allo-HSCT). CD45RA memory T cells confer protection against viruses such as cytomegalovirus, Epstein-Barr virus, and adenovirus; however, reports have shown an unexpectedly high incidence of human herpesvirus (HHV)-6B encephalitis among pediatric allo-HSCT patients.

Methods: We report the first 18 consecutive allo-HSCT, 16 haplo-HSCT, and two human leukocyte antigen-matched related donors implanted with naïve TCD grafts. Read More

Int J Mol Sci 2021 Feb 27;22(5). Epub 2021 Feb 27.

Institute of Microbiology and Virology, Rīga Stradiņš University, Rātsupītes str. 5, LV-1067 Rīga, Latvia.

During persistent human beta-herpesvirus (HHV) infection, clinical manifestations may not appear. However, the lifelong influence of HHV is often associated with pathological changes in the central nervous system. Herein, we evaluated possible associations between immunoexpression of HHV-6, -7, and cellular immune response across different brain regions. Read More

Int J Mol Sci 2021 Feb 21;22(4). Epub 2021 Feb 21.

Department of Dermatology, Nara Medical University School of Medicine, Nara 634-8522, Japan.

Drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms (DIHS/DRESS) is a severe type of adverse drug eruption associated with multiorgan involvement and the reactivation of human herpesvirus 6, which arises after prolonged exposure to certain drugs. Typically, two waves of disease activity occur during the course of DIHS/DRESS; however, some patients experience multiple waves of exacerbation and remission of the disease. Severe complications, some of which are related to cytomegalovirus reactivation, can be fatal. Read More

Hemasphere 2021 Mar 17;5(3):e535. Epub 2021 Feb 17.

Department of Haematology, Kings College Hospital, London, United Kingdom.

Pediatr Allergy Immunol 2021 Feb 23. Epub 2021 Feb 23.

Faculty of Medicine, University of Belgrade, Belgrade, Serbia.

Childhood rashes or exanthemas are common and are usually relatively benign. There are many causes of rash in children, including mainly viruses, and less often bacterial toxins, drugs, allergens and other diseases. Viral exanthema often appears while children are taking a medication in the course of a viral infection; it can mimic drug exanthema and is perceived as a drug allergy in 10% of cases. Read More