title: Effect of antivirals on human herpesvirus 6 replication in hematopoietic stem cell transplant recipients.
abstract: Human herpesvirus 6 (HHV-6) appears to cause central nervous system (CNS) syndromes, especially in hematopoietic stem cell transplant (HSCT) recipients. We reviewed our experience with HHV-6-associated CNS disease to evaluate both the clinical and virological presentation and response to antiviral therapy. A search of our virology database from January 1998 through June 2000 identified 11 HSCT recipients who had HHV-6 DNA detected by polymerase chain reaction in cerebrospinal fluid (CSF); 8 of whom had CNS dysfunction without another clear etiology identified. HHV-6 levels in serum and CSF were evaluated before and after ganciclovir and/or foscarnet therapy. Median log HHV-6 CSF levels appeared to decrease over time concurrent with antiviral therapy (serum level, 2.0 vs. 0 copies/mL [P=.38]; CSF level, 4.4 vs. 2.0 copies/mL [P=.13], sign test). Our data suggests that HHV-6 may cause moderate to severe CNS disease after HSC transplantation. Prospective studies are needed to define the spectrum of HHV-6-associated disease and to determine whether antiviral therapy offers clinical benefit.
authors.affiliation: Department of Pediatrics, University of Washington, Seattle, WA, USA. zerr@u.washington.edu
authors.forename: Danielle M
authors.initials: DM
authors.lastname: Zerr
authors.forename: Deepti
authors.initials: D
authors.lastname: Gupta
authors.forename: Meei-Li
authors.initials: ML
authors.lastname: Huang
authors.forename: Rachel
authors.initials: R
authors.lastname: Carter
authors.forename: Lawrence
authors.initials: L
authors.lastname: Corey
mesh_terms: D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000494:pharmacology*; D002648:Child; D004279:DNA, Viral / Q000134:cerebrospinal fluid / Q000187:drug effects*; D004660:Encephalitis / Q000150:complications / Q000821:virology; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D015654:Herpesvirus 6, Human / Q000145:classification / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019349:Roseolovirus Infections / Q000150:complications; D014779:Virus Replication
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral