Evidence map›Paper›PMID 38768311›Full record

ArticleThe Journal of infectious diseases2025

Reactivation of a Transplant Recipient's Inherited Human Herpesvirus 6 and Implications to the Graft.

Leo Hannolainen, Lari Pyöriä, Diogo Pratas, Jouko Lohi, Sandra Skuja, Santa Rasa-Dzelzkaleja, Modra Murovska, Klaus Hedman, Timo Jahnukainen, Maria Fernanda Perdomo

Abstract readCase Reports
In one paragraph

Article in The Journal of infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
  2. Article
  3. Endogenous human herpesviruses 6A/B.Journal of virology · 2025
    Article
  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Leo HannolainenDepartment of Virology, University of Helsinki and Helsinki University Hospital, Finland.ORCID 0009-0005-5982-413X
Lari PyöriäDepartment of Virology, University of Helsinki and Helsinki University Hospital, Finland.ORCID 0000-0001-9504-5807
Diogo PratasDepartment of Virology, University of Helsinki and Helsinki University Hospital, Finland.ORCID 0000-0003-1176-552X
Jouko LohiDepartment of Pathology, University of Helsinki and Helsinki University Hospital, Finland.
Sandra SkujaJoint Laboratory of Electron Microscopy, Institute of Anatomy and Anthropology.ORCID 0000-0002-3589-9429
Santa Rasa-DzelzkalejaInstitute of Microbiology and Virology, Rīga Stradiņš University, Riga, Latvia.ORCID 0000-0001-6519-7121
Modra MurovskaInstitute of Microbiology and Virology, Rīga Stradiņš University, Riga, Latvia.ORCID 0000-0003-0971-1784
Klaus HedmanDepartment of Virology, University of Helsinki and Helsinki University Hospital, Finland.ORCID 0000-0003-1779-7960
Timo JahnukainenDepartment of Pediatric Nephrology and Transplantation, Children's Hospital and Helsinki University Hospital, Finland.ORCID 0000-0002-1815-7327
Maria Fernanda PerdomoDepartment of Virology, University of Helsinki and Helsinki University Hospital, Finland.ORCID 0000-0002-9031-4251

Funding

Finnish Medical FoundationFinska LäkaresällskapetFundação para a Ciência e a Tecnologia UIDB/00127/2020Helsinki University Hospital Research and Education FundJane and Aatos Erkko FoundationLife and Health Medical FoundationMagnus Ehrnrooth FoundationRīga Stradiņš University Research Grant 6-ZD-22/4/2023
6 · The paper itself

Abstract

backgroundThe implications of inherited chromosomally integrated human herpesvirus 6 (iciHHV-6) in solid organ transplantation remain uncertain. Although this trait has been linked to unfavorable clinical outcomes, an association between viral reactivation and complications has only been conclusively established in a few cases.

methodsWe used hybrid capture sequencing for in-depth analysis of the viral sequences reconstructed from sequential liver biopsies. Moreover, we investigated viral replication through in situ hybridization (U38-U94 genes), reverse transcriptase polymerase chain reaction (U89/U90 genes), immunohistochemistry, and immunofluorescence. We also performed whole transcriptome sequencing to profile the host immune response.

resultsWe report a case of reactivation of a recipient's iciHHV-6B and subsequent infection of the graft. Using a novel approach integrating the analysis of viral and mitochondrial DNAs, we located the iciHHV-6B intragraft. We demonstrated active replication via the emergence of viral minor variants, in addition to positive viral messenger RNAs and antigen stainings in tissue sections. Furthermore, we detected significant upregulation of antiviral immune responses, arguing against immunotolerance.

conclusionsOur analysis underscores the potential pathological impact of iciHHV-6B, emphasizing the need for monitoring reactivation in transplant recipients. Most crucially, it highlights the critical role that the host's virome can play in shaping the outcome of transplantation.

Indexed as

Herpesvirus 6, HumanLiver TransplantationRoseolovirus InfectionsTransplant RecipientsVirus ActivationDNA, ViralHumansLiverVirus ReplicationDNA, Viralhost immune profilinginherited chromosomally integrated human herpesvirus 6reactivationtransplantationvirome

Identifiers

PMID38768311
PMCPMC11841639

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.