EBMT 2025 | The clinical impact of HHV-6 in transplantation and CAR-T
In this video, Eleftheria Kampouri, MD, University of Lausanne, Lausanne, Switzerland, comments on the clinical impact of human herpesvirus 6 (HHV-6) infection in transplantation and CAR T-cell therapy, discussing the highlights from a session on this topic at the EBMT 2025 meeting. Dr Kampouri outlines the difficulties in diagnosing and treating HHV-6, particularly in cases of chromosomal integration, and looks forward to the development of more standardized diagnostic tools in the future. This interview took place at the 51st Annual Meeting of the EBMT in Florence, Italy.
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Transcript
That was such an interesting session because we talked more globally about HHV-6. You know, we think that the epidemiology might be shifting because transplant practices are shifting. We’re now using more letermovir for CMV prophylaxis, which has led to a decrease in the broad spectrum antivirals that normally we would have given for preemptive therapy of CMV...
That was such an interesting session because we talked more globally about HHV-6. You know, we think that the epidemiology might be shifting because transplant practices are shifting. We’re now using more letermovir for CMV prophylaxis, which has led to a decrease in the broad spectrum antivirals that normally we would have given for preemptive therapy of CMV. So these all can kind of impact the HHV-6 epidemiology. Good news is that we’re not seeing any increasing signals at this point.
Another important aspect was that, you know, HHV-6 has been implicated in a lot of different manifestations. And now we have a solid level of evidence to kind of really support these associations. And I think the most important is the role of HHV-6 as a long pathogen with the Nature Communications paper from the Fred Hutchinson, the Seattle group that came out that showed that we could even have cut-offs that are associated with increased mortality or the risk of lytic infection.
We also discussed about viral kinetics and how difficult it is to have a viral threshold above which to worry about encephalitis. Spoiler alert, we do not think that we should be having a cut-off, a specific cut-off, it’s more you know the general clinical context that should guide us.
And then finally we talked a little bit about the challenges in diagnosis and we know that we have inherited chromosomal integration which is kind of a very rare and unique condition that we see with HHV-6, but which leads to very high viral loads without having disease, and this is not something that requires treatment, but very often confounds diagnosis. So it was very interesting to talk about the algorithm, how to approach that part.
I think that in the future we will probably be able to have more widely accessible and standardized diagnostic tools to be able to tell apart reactivation from integration, which is not the case yet. Yeah, so lots of interesting stuff and discussions about how to diagnose and treat and even try to prevent HHV-6.
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Disclosures
Participation in advisory boards and support for conference from Merck; Grants from: Swiss National Science Foundation (P500PM_202961); Santos Suarez Foundation Switzerland; SICPA Foundation Switzerland; Dharam Ablashi Research Fund, Pilot Grant by HHV-6 Foundation.
