Ganciclovir is effective for prophylaxis and treatment of human herpesvirus-6 in allogeneic stem cell transplantation.
Human herpesvirus 6 (HHV-6) infection and disease are serious complications of allogeneic hematopoietic stem cell transplantation (allo-SCT). Ganciclovir (GCV) is effective against HHV-6 in vitro but the antiviral susceptibility of HHV-6 has not been well characterized in vivo. We retrospectively compared the HHV-6 reactivation rate in pediatric allo-SCT recipients with and without GCV prophylaxis. The HHV-6 reactivation rate at 3 weeks after allo-SCT in patients without prophylactic GCV administration was significantly higher than that in those receiving prophylactic GCV (11/28 vs 0/13, P < 0.01). Five of 36 patients without prophylactic GCV showed clinical manifestations including skin rash, interstitial pneumonitis, persistent thrombocytopenia, enterocolitis and thrombotic microangiopathy, respectively. HHV-6-associated symptoms were observed in one of the 13 patients receiving prophylactic GCV. This patient showed fever, diarrhea and graft rejection concomitantly with a sudden increase of HHV-6 DNA copy number. Patients who received GCV for treatment of HHV-6 infection showed an improvement in symptoms and/or decrease of HHV-6 copy number. Thus, GCV is effective for treating HHV-6 disease after allo-SCT in vivo.
Tokimasa
S
S
Department of Developmental Medicine (Pediatrics) D-5, Osaka University Graduate School of Medicine, Osaka, Japan.
Hara
J
J
Osugi
Y
Y
Ohta
H
H
Matsuda
Y
Y
Fujisaki
H
H
Sawada
A
A
Kim
J Y
JY
Sashihara
J
J
Amou
K
K
Miyagawa
H
H
Tanaka-Taya
K
K
Yamanishi
K
K
Okada
S
S
D000998:Antiviral Agents / Q000627:therapeutic use*; D002648:Child; D004279:DNA, Viral / Q000097:blood; D004341:Drug Evaluation; D005260:Female; D015774:Ganciclovir / Q000627:therapeutic use*; D018380:Hematopoietic Stem Cell Transplantation; D006562:Herpes Zoster / Q000517:prevention & control; D015654:Herpesvirus 6, Human / Q000187:drug effects* / Q000254:growth & development / Q000302:isolation & purification; D006801:Humans; D008297:Male; D016133:Polymerase Chain Reaction; D012189:Retrospective Studies; D019349:Roseolovirus Infections / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control*; D014184:Transplantation, Homologous; D014766:Viremia / Q000188:drug therapy; D014775:Virus Activation / Q000187:drug effects
D000998:Antiviral Agents; D004279:DNA, Viral; D015774:Ganciclovir