Human herpesvirus 6 infections after bone marrow transplantation: clinical and virologic manifestations.
Human herpesvirus 6 (HHV-6) DNA levels in peripheral blood mononuclear cells were prospectively evaluated in 20 cytomegalovirus-seronegative allogeneic marrow transplant patients and in 10 healthy control subjects. Blood and saliva specimens obtained weekly for 3 months after transplant were evaluated by quantitative HHV-6 polymerase chain reaction. One of 20 patients experienced primary HHV-6 infection after marrow transplant (seroconversion, HHV-6 viremia, skin rash); 18 of 20 had increased peripheral blood mononuclear cell HHV-6 DNA levels consistent with asymptomatic reactivations, and 1 patient experienced a reactivation-associated skin rash. Genotyping revealed HHV-6 variant B DNA in all cases. Therapy with acyclovir or intravenous immunoglobulin was not correlated with lower HHV-6 DNA levels. Thus, asymptomatic HHV-6 reactivations appear to be common following allogeneic marrow transplantation. Among HHV-6-seronegative and viral DNA-negative patients, primary HHV-6 infection can ensue in association with self-limited clinical symptoms, including diffuse maculopapular rash.
Cone
R W
RW
Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA.
Huang
M L
ML
Corey
L
L
Zeh
J
J
Ashley
R
R
Bowden
R
R
D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D015331:Cohort Studies; D003587:Cytomegalovirus / Q000276:immunology; D004279:DNA, Viral / Q000097:blood; D005076:Exanthema / Q000209:etiology; D005260:Female; D005334:Fever / Q000209:etiology; D006566:Herpesviridae Infections / Q000209:etiology / Q000821:virology*; D015654:Herpesvirus 6, Human; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014184:Transplantation, Homologous; D014775:Virus Activation
D004279:DNA, Viral