Human herpesvirus 6: infection and disease following autologous and allogeneic bone marrow transplantation.
Human herpesvirus 6 activity (HHV-6) was studied in 15 allogeneic and 11 autologous marrow transplantation patients. After transplantation, HHV-6 was isolated from the peripheral blood mononuclear cells of 12 of 26 patients (6 allogeneic and 6 autologous). All isolates were variant B. Eleven of 26 and 12 of 19 patients showed salivary shedding of HHV-6 DNA before and after transplantation, respectively. The antibody titer increased in 7 of 26 patients. Thus, 23 of 26 patients showed evidence of active HHV-6 infection either by virus isolation, salivary shedding, or increases in antibody titers. The fraction of saliva specimens positive in 19 patients was negatively associated with their antibody titers (P= .005). The proportion of cultures positive increased after transplantation (P = .007). Sinusitis was associated with HHV-6 isolation in autologous recipients (P= .002). In allogeneic patients, active human cytomegalovirus infection was associated with HHV-6 isolation (P = .04). No association was observed between HHV-6 infection and GVHD, pneumonia, delay in engraftment, or marrow suppression. Of the 120 clinical events analyzed in 26 patients, HHV-6 was defined as a probable cause of 16 events in 9 patients based on the propinquity of HHV-6 activity and the clinical event plus the absence of other identified causes of the event.
Kadakia
M P
MP
Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, PA 15261, USA.
Rybka
W B
WB
Stewart
J A
JA
Patton
J L
JL
Stamey
F R
FR
Elsawy
M
M
Pellett
P E
PE
Armstrong
J A
JA
D000328:Adult; D001483:Base Sequence; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000453:epidemiology / Q000628:therapy; D015897:Comorbidity; D003586:Cytomegalovirus Infections / Q000453:epidemiology; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006086:Graft vs Host Disease / Q000453:epidemiology; D006562:Herpes Zoster / Q000453:epidemiology; D006566:Herpesviridae Infections / Q000453:epidemiology / Q000209:etiology*; D015654:Herpesvirus 6, Human / Q000145:classification / Q000302:isolation & purification* / Q000502:physiology; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D007239:Infections / Q000453:epidemiology; D007938:Leukemia / Q000453:epidemiology / Q000628:therapy; D007963:Leukocytes, Mononuclear / Q000821:virology; D015993:Life Tables; D008223:Lymphoma / Q000453:epidemiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D010051:Ovarian Neoplasms / Q000453:epidemiology / Q000628:therapy; D010414:Pennsylvania / Q000453:epidemiology; D010865:Pilot Projects; D011446:Prospective Studies; D012852:Sinusitis / Q000453:epidemiology / Q000821:virology; D016019:Survival Analysis; D014182:Transplantation, Autologous / Q000009:adverse effects; D014184:Transplantation, Homologous / Q000009:adverse effects; D016896:Treatment Outcome; D014775:Virus Activation
D004279:DNA, Viral