The Journal of Heart and Lung Transplantation
International Society for Heart and Lung Transplantation.

Possible progesterone-induced gestational activation of chromosomally integrated human herpesvirus 6B and transplacental transmission of activated human herpesvirus 6B

      A 4-day-old infant presented with heart failure. His echocardiogram showed a markedly dilated left ventricle and severely decreased systolic function (left ventricular ejection fraction 20%). After birth, the patient was found to have inherited chromosomally integrated human herpesvirus 6B (ciHHV-6B), as the virus copy number was approximately 1 copy per cell as detected by droplet digital polymerase chain reaction (ddPCR) assay for HHV-6B. His mother tested positive for HHV-6 chromosomal integration by droplet digital PCR, confirming ciHHV-6B status in both the patient and his mother (Table 1). Despite inotropy and supportive care, the patient died of multi-organ failure secondary to worsening heart failure.
      Table 1Summary of Quantitative Polymerase Chain Reaction Results
      Sample Patient’s DNA from peripheral blood Mother’s DNA from peripheral blood HHV-6A-positive control HHV-6B-positive control Negative control for HHV-6A Negative control for HHV-6B
      HHV-6A/HHV-6B B B A B NA NA
      HHV-6 copies/ml 212 247 20.7 48 0 0
      RPP30 copies/ml 394 441 37.5 99 0 0
      HHV-6/cell 1.08 1.12 1.104 0.9697 0 0
      Blood-derived DNA samples from the patient and his mother were analyzed by droplet digital PCR assay with HHV-6A and HHV-6B, RPP30 cellular reference gene, and positive and negative controls. Both the patient and the mother tested negative for HHV-6A.
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