The importance of human herpesvirus 6 (HHV-6) species as human pathogens is increasingly appreciated. However, we do not understand how infection is controlled in healthy virus carriers, and why control fails in patients with disease. Other persistent viruses are under continuous surveillance by antigen-specific T cells, and specific T-cell repertoires have been well characterized for some of them. In contrast, knowledge on HHV-6-specific T-cell responses is limited, and missing for CD8 + T cells. Here we identify CD8 + T-cell responses to HHV-6B, the most widespread HHV-6 species, in healthy virus carriers. HHV-6B-specific CD8 + T-cell lines and clones recognized HLA-A2-restricted peptides from the viral structural proteins U54 and U11, and displayed various antigenspecific antiviral effector functions. These CD8 + T cells specifically recognized HHV-6B-infected primary CD4 + T cells in an HLA-restricted manner, produced antiviral cytokines, and killed infected cells, whereas HHV-6A-infected cells were not recognized. Thus, HHV-6B-specific CD8 + T cells are likely to contribute to control of infection, overcoming the immunomodulatory effects exerted by the virus. Potentially, HHV-6-associated disease could be addressed by active or passive immunotherapy that reconstitutes virusspecific CD8 + T-cell responses.
Keywords: CD8+ T cells r human herpesvirus 6B r infectious diseases r virology
IntroductionHuman herpesvirus 6 (HHV-6) species are widespread pathogens, and more than 90% of humans are seropositive. The two species HHV-6A and HHV-6B have close sequence homology but differ in their epidemiology and pathogenicity [1,2]. Primary infection with HHV-6B, the more widespread species, usually takes place in early childhood and is often associated with a self-limiting illness known as three-day fever or exanthema subitum [3,4]. After primary infection, HHV-6 remains in a latent state in its immunocompetent host [5], and occasional reactivations are normally asymptomatic. However, HHV-6 (in most cases HHV-6B) can reactivate in immunosuppressed individuals. HHV-6B reactivation is observed in 40-50% of patients receiving stem cell transCorrespondence: Dr. Andreas Moosmann e-mail: andreas.moosmann@helmholtz-muenchen.de plantation, and viral reactivation is associated with delirium and cognitive decline, severe encephalitis, graft-versus-host disease, transplant failure, and overall mortality [6][7][8][9]. Apart from the immunosuppressed host, HHV-6 has been involved in a variety of diseases involving the CNS, such as febrile seizures, encephalitis, epilepsy, and multiple sclerosis [2,10]. Healthy humans frequently carry a number of other persistent viruses that may reactivate under immunosuppression, including the herpesvirus family members Epstein-Barr virus (EBV) and cytomegalovirus (CMV) [11]. It is assumed that these viruses are under continuous control by antigen-specific T cells, and viral reactivation results from a deficiency in virus-specific T cells caused by therapy-related immunosuppression [11]. In accorda...