Human Polyomavirus 9-An Emerging Cutaneous and Pulmonary Pathogen in Solid Organ Transplant Recipients

Area of Science:

• Virology
• Immunology
• Dermatology

Background:

• Solid organ transplant recipients are susceptible to opportunistic infections.
• Human polyomaviruses are known to cause disease in immunocompromised individuals.

Purpose of the Study:

• To report the first known cases of cutaneous and systemic disease caused by human polyomavirus 9 (HPyV9) in solid organ transplant recipients.
• To investigate the role of HPyV9 in a fatal, widespread skin eruption.

Main Methods:

• A case series of three solid organ transplant recipients with unexplained skin lesions.
• High-throughput sequencing of lesional skin biopsies.
• In situ hybridization and quantitative PCR assays on various patient samples and autopsy tissues.

Main Results:

• HPyV9 was identified in skin biopsies from all three patients.
• HPyV9 DNA and mRNA were detected in multiple tissues, including skin, blood, and lungs, indicating active viral replication.
• All patients developed progressive cutaneous disease and died from multiorgan failure.

Conclusions:

• HPyV9 is associated with a severe, progressive cutaneous eruption and systemic disease in solid organ transplant recipients.
• The findings suggest HPyV9 can cause fatal pulmonary and multiorgan failure.
• Early identification and understanding of HPyV9 pathogenesis are crucial for managing immunocompromised patients.