{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T09:37:48Z","timestamp":1763113068814,"version":"3.45.0"},"reference-count":42,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T00:00:00Z","timestamp":1762992000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Human herpesvirus 6 (HHV-6) is a common virus that can reactivate in immunocompromised patients, including lung transplant (LT) recipients. This study aimed to evaluate the clinical and functional implications of HHV-6 infection in LT patients through a retrospective analysis of 175 individuals who underwent lung transplantation at the City of Health and Sciences of Turin between 2014 and 2023. Surveillance bronchoscopies\u2014including bronchoalveolar lavage (BAL) and transbronchial biopsies\u2014were performed at scheduled intervals over a two-year period to detect HHV-6 and other pathogens, and to assess acute rejection. Spirometries were performed to evaluate graft function. Among the cohort, 33% of 822 BAL samples tested were positive for HHV-6, with a notable association between high viral load (\u2265500 copies\/mL) and the development of post-transplant lymphoproliferative disorder (PTLD) (13% vs. 1%, p = 0.02) at 1 month and (9% vs. 1%, p = 0.026) at 12 months. Co-infection with CMV (78% in positives vs. 55% in negatives; p = 0.006), Epstein\u2013Barr virus (EBV) (35% vs. 16%; p = 0.010), and bacterial and fungal infection (specifically, a higher rate of isolation of Achromobacter xylosoxidans (13%), p = 0.010) was frequently observed in conjunction with HHV-6 positivity. Notably, patients with at least one HHV-6 positive BAL exhibited a significant reduction in forced vital capacity (FVC) at multiple follow-up points, FVC 82% in positives vs. 92% in negatives (p = 0.038) at 4 months and 87% vs. 98% p = 0.033 at 8 months and 87% vs. 99% p = 0.038 at 24 months. No direct associations with acute rejection or overall survival were found. By means of this study, we provide a wide overview of HHV-6 in lung transplant recipients, filling in a gap of evidence in the field. We report a remarkable incidence and a significant association with acknowledged clinically relevant viral infections, PTLD, and functional tests decline, with no association with mortality.<\/jats:p>","DOI":"10.3390\/pathogens14111157","type":"journal-article","created":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T09:06:36Z","timestamp":1763111196000},"page":"1157","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Human Herpes Virus\u2014Six Related Clinical and Functional Implications in Lung Transplant Patients: Bronco Alveolar Lavage Analysis, Coinfections, Rejection, and Survival"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3972-2871","authenticated-orcid":false,"given":"Paolo","family":"Solidoro","sequence":"first","affiliation":[{"name":"Division of Respiratory Medicine, Cardiovascular and Thoracic Department, AOU Citt\u00e0 Della Salute e Della Scienza di Torino, University of Turin, 10126 Torino, Italy"},{"name":"Medical Sciences Department, University of Turin, 10126 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8101-4196","authenticated-orcid":false,"given":"Antonio","family":"Curtoni","sequence":"additional","affiliation":[{"name":"Division of Virology, Department of Laboratory Medicine Public Health and Pediatrics, AOU Citt\u00e0 Della Salute e Della Scienza di Torino, University of Turin, 10126 Torino, Italy"},{"name":"Department of Public Health and Paediatrics, University of Turin, 10124 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Costanza","family":"Perotti","sequence":"additional","affiliation":[{"name":"Division of Respiratory Medicine, Cardiovascular and Thoracic Department, AOU Citt\u00e0 Della Salute e Della Scienza di Torino, University of Turin, 10126 Torino, Italy"},{"name":"Medical Sciences Department, University of Turin, 10126 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camilla","family":"Perotti","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Rita Levi Montalcini, University of Turin, 10126 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nour","family":"Shbaklo","sequence":"additional","affiliation":[{"name":"Medical Sciences Department, University of Turin, 10126 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5241-5273","authenticated-orcid":false,"given":"Francesca","family":"Sidoti","sequence":"additional","affiliation":[{"name":"Division of Virology, Department of Laboratory Medicine Public Health and Pediatrics, AOU Citt\u00e0 Della Salute e Della Scienza di Torino, University of Turin, 10126 Torino, Italy"},{"name":"Department of Public Health and Paediatrics, University of Turin, 10124 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauro","family":"Mangiapia","sequence":"additional","affiliation":[{"name":"Division of Respiratory Medicine, Cardiovascular and Thoracic Department, AOU Citt\u00e0 Della Salute e Della Scienza di Torino, University of Turin, 10126 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8338-0130","authenticated-orcid":false,"given":"Francesco Giuseppe","family":"De Rosa","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, 10149 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Corcione","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, 10149 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Boffini","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Division, Cardiovascular and Thoracic Department, AOU Citt\u00e0 Della Salute e Della Scienza di Torino, 10124 Torino, Italy"},{"name":"Surgical Sciences Department, AOU Citt\u00e0 della Salute e della Scienza di Torino, University of Turin, 10126 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4118-8930","authenticated-orcid":false,"given":"Matteo","family":"Marro","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Division, Cardiovascular and Thoracic Department, AOU Citt\u00e0 Della Salute e Della Scienza di Torino, 10124 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6549-4553","authenticated-orcid":false,"given":"Cristina","family":"Costa","sequence":"additional","affiliation":[{"name":"Division of Virology, Department of Laboratory Medicine Public Health and Pediatrics, AOU Citt\u00e0 Della Salute e Della Scienza di Torino, University of Turin, 10126 Torino, Italy"},{"name":"Department of Public Health and Paediatrics, University of Turin, 10124 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3999-5298","authenticated-orcid":false,"given":"Rocco Francesco","family":"Rinaldo","sequence":"additional","affiliation":[{"name":"Division of Respiratory Medicine, Cardiovascular and Thoracic Department, AOU Citt\u00e0 Della Salute e Della Scienza di Torino, University of Turin, 10126 Torino, Italy"},{"name":"Medical Sciences Department, University of Turin, 10126 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.1016\/j.healun.2021.07.005","article-title":"Consensus document for the selection of lung transplant candidates: An update from the International Society for Heart and Lung Transplantation","volume":"40","author":"Leard","year":"2021","journal-title":"J. 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Virol."}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/14\/11\/1157\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T09:33:02Z","timestamp":1763112782000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/14\/11\/1157"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,13]]},"references-count":42,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["pathogens14111157"],"URL":"https:\/\/doi.org\/10.3390\/pathogens14111157","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,13]]}}}