title: Human herpesvirus 6 reactivation and encephalitis in allogeneic bone marrow transplant recipients.
abstract: To determine whether receipt of an investigational anti-CD3 monoclonal antibody (BC3) increased the risk of human herpesvirus 6 (HHV-6) reactivation and development of encephalitis in bone marrow transplant (BMT) recipients, persons who had and had not received BC3 were compared. Odds of HHV-6 reactivation were higher among BC3 recipients than among control patients (odds ratio, 2.5; 95% confidence interval [CI], 1.3-4.7). In addition, BC3 recipients were more likely than control patients to develop encephalitis (risk ratio [RR], 3.5; 95% CI, 1.3-9.5), and this association followed a BC3 dose-dependent relationship (P=.03, by Mantel-Haenszel chi(2) test). In a multivariable model, HHV-6 reactivation and receipt of BC3 were associated with increased risk of encephalitis (RR, 5.4; 95% CI, 1.9-15.3, and RR, 3.3; 95% CI, 1.2-9.1, respectively). In conclusion, both HHV-6 reactivation and receipt of BC3 for prophylaxis of acute graft-versus-host disease independently increased the risk of encephalitis in allogeneic BMT recipients. Prospective studies to better define the relationship between HHV-6 reactivation and encephalitis in allogeneic BMT recipients are warranted.
authors.affiliation: Department of Pediatrics, University of Washington, Seattle, WA, USA. zerr@u.washington.edu
authors.forename: D M
authors.initials: DM
authors.lastname: Zerr
authors.forename: T A
authors.initials: TA
authors.lastname: Gooley
authors.forename: L
authors.initials: L
authors.lastname: Yeung
authors.forename: M L
authors.initials: ML
authors.lastname: Huang
authors.forename: P
authors.initials: P
authors.lastname: Carpenter
authors.forename: J C
authors.initials: JC
authors.lastname: Wade
authors.forename: L
authors.initials: L
authors.lastname: Corey
authors.forename: C
authors.initials: C
authors.lastname: Anasetti
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects*; D016026:Bone Marrow Transplantation / Q000009:adverse effects* / Q000276:immunology; D017252:CD3 Complex; D018792:Encephalitis, Viral / Q000209:etiology*; D005260:Female; D006086:Graft vs Host Disease / Q000517:prevention & control; D006566:Herpesviridae Infections / Q000209:etiology*; D015654:Herpesvirus 6, Human / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors
chemical_list: D000911:Antibodies, Monoclonal; D017252:CD3 Complex