High levels of human herpesvirus 6 DNA in peripheral blood leucocytes are correlated to platelet engraftment and disease in allogeneic stem cell transplant patients.
The aim of this study was to correlate human herpesvirus (HHV)-6 viral load with clinical symptoms in allogeneic stem cell transplant (SCT) patients. Seventy-four patients were monitored during the first 3 months after SCT using a qualitative polymerase chain reaction (PCR) for HHV-6 DNA. HHV-6 was detected in 181 out of 494 samples (36%) from 58 (78%) patients. These 181 samples were analysed using a quantitative competitive PCR. DNA could be quantified from 146 out of 181 samples (80.6%). The HHV-6 viral load was highest at 4 weeks compared with 8 weeks (P < 0.001) and 12 weeks (P = 0.01) after SCT. Three patients had HHV-6 encephalitis and one patient had hepatitis. The HHV-6 DNA levels were higher in patients with HHV-6 than in those without HHV-6 (P = 0.01). Patients who received grafts from unrelated or HLA-mismatched family donors had significantly higher HHV-6 DNA levels than patients who received grafts from matched sibling donors (P < 0.001). In a multiple regression model, unrelated donor grafts (P < 0.001) and use of intravenous immunoglobulin prophylaxis (P = 0.04) influenced HHV-6 DNA levels. HHV-6 viral load was significantly correlated with delayed platelet engraftment in both univariate (P < 0.01) and multivariate analysis, and to the number of platelet transfusions.
Ljungman
P
P
Department of Haematology, Huddinge University Hospital, Karolinska Institutet, Stockholm, Sweden. Per.Ljungman@medhs.ki.se
Wang
F Z
FZ
Clark
D A
DA
Emery
V C
VC
Remberger
M
M
Ringdén
O
O
Linde
A
A
D000212:Acyclovir / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D001792:Blood Platelets / Q000821:virology; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D002493:Central Nervous System Diseases / Q000821:virology; D002648:Child; D002675:Child, Preschool; D003587:Cytomegalovirus / Q000235:genetics; D004279:DNA, Viral / Q000032:analysis*; D005260:Female; D006086:Graft vs Host Disease; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006505:Hepatitis / Q000821:virology; D006566:Herpesviridae Infections / Q000276:immunology / Q000517:prevention & control / Q000635:transmission*; D015654:Herpesvirus 6, Human / Q000235:genetics*; D006650:Histocompatibility Testing; D006801:Humans; D016756:Immunoglobulins, Intravenous; D007962:Leukocytes / Q000821:virology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017713:Platelet Transfusion; D016133:Polymerase Chain Reaction; D011184:Postoperative Period; D011446:Prospective Studies; D014184:Transplantation, Homologous; D019562:Viral Load
D000998:Antiviral Agents; D004279:DNA, Viral; D016756:Immunoglobulins, Intravenous; D000212:Acyclovir