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Fatal outcome after reactivation of inherited chromosomally integrated HHV ‐6A (ici HHV ‐6A) transmitted through liver transplantation
Author(s) -
Bonnafous P.,
Marlet J.,
Bouvet D.,
Salamé E.,
Tellier A.C.,
Guyetant S.,
Goudeau A.,
Agut H.,
GautheretDejean A.,
GaudyGraffin C.
Publication year - 2018
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.14657
Subject(s) - transplantation , transmission (telecommunications) , medicine , mendelian inheritance , population , stem cell , virology , somatic cell , horizontal transmission , immunology , biology , gene , genetics , virus , environmental health , engineering , electrical engineering
HHV ‐6A and HHV ‐6B are found as inherited and chromosomally integrated forms (ici HHV ‐6A and ‐6B) into all germinal and somatic cells and vertically transmitted in a Mendelian manner in about 1% of the population. They were occasionally shown to be horizontally transmitted through hematopoietic stem cell transplantation. Here, we present a clinical case of horizontal transmission of ici HHV ‐6A from donor to recipient through liver transplantation. Molecular analysis performed on three viral genes (7.2 kb) in the recipient and donor samples supports transmission of ici HHV ‐6A from the graft. Transmission was followed by reactivation, with high viral loads in several compartments. The infection was uncontrollable, leading to severe disease and death, despite antiviral treatments and the absence of resistance mutations. This case highlights the fact that physicians should be aware of the possible horizontal transmission of ici HHV ‐6 and its consequences in case of reactivation in immunocompromised patients.