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Adverse Occurrence type:
Alerting signals, symptoms, evidence of occurrence:
Investigated for hepatitis and pancreatitis 5 years after unrelated BM transplantation at age 10, diagnosis of gallstones. Treated for chronic GvHD and monitored for opportunistic viral infections, found to have high levels of HHV-6 in the peripheral blood. As there was no response to foscarnet, chromosomal integration was suspected and confirmed. Clinically improved and remained well 4 years after this episode.
Demonstration of imputability or root cause:
Chromosomal integration of HHV-6. Stored donor and recipient samples were tested with a high genome of 1.25x10(7) copies/ug DNA in the donor's blood but not in the recipient's sample. FISH confirmed integration of HHV-6B genome into the donor's chromosome Xp subtelomeric region. No HHV6-related symptoms, viral DNA detected 5 years post -transplant, as part of routine monitoring during immunosuppressive therapy.
Yagasaki H, Shichino N, Shimizu T et al. Nine-year follow up in a child with chromosomal integration of human herpesvirus 6 transmitted from an unrelated donor through the Japan Marrow Donor Program. Transplant Infectious Disease 2015:17(1): 160-161.
Add HHV6 to the adverse occurrence taxonomy: Harm to a recipient/Infection/Viral/Human Herpes Virus 6 (HHV-6)