High incidence of human herpesvirus 6 infection with a high viral load in cord blood stem cell transplant recipients.
Human herpesvirus 6 (HHV-6) infection in recipients of cord blood stem cell transplants (CBSCTs) was estimated by semiquantitative and real-time quantitative polymerase chain reaction (PCR) and reverse-transcription PCR. Of the CBSCT recipients, 7 (70%) of 10 had active HHV-6 infection after transplantation, and all 7 were inferred from their age to have already had a primary infection. Because HHV-6 DNA is seldom detected in cord blood, these cases were considered likely to represent reactivation. In contrast, the 3 patients without HHV-6 infection were all believed to be naive regarding HHV-6 primary infection because of their age and the results of PCR assays given before the transplantation procedure. The incidence of HHV-6 infection after transplantation was significantly higher (P <.05) than after bone marrow (BM) transplantation and peripheral blood stem cell (PBSC) transplantation, when recipients without primary HHV-6 infection prior to transplantation were excluded (CBSCT, 100%; BMT/PBSCT, 56.3%). Real-time PCR revealed a higher level of viral DNA in the peripheral blood mononuclear cells from CBSCT recipients than from BMT/PBSCT recipients or patients with exanthem subitum (P <.05). HHV-6 mRNA of the U79/80 gene was also detected by reverse-transcription PCR in all analyzed patients with HHV-6 infection. Its detection was correlated with the emergence of viral DNA in the plasma and symptoms such as fever and rash. Thus, HHV-6 infection was more frequent and the viral load was higher in CBSCT recipients with prior primary infection.
Department of Developmental Medicine (Pediatrics) D-5, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita City, Osaka 565-0871, Japan. sashi@ped.med.osaka-u.ac.jp
Junji
J
Sashihara
Keiko
K
Tanaka-Taya
Shinya
S
Tanaka
Kiyoko
K
Amo
Hiromi
H
Miyagawa
Gaku
G
Hosoi
Tomokuni
T
Taniguchi
Takafumi
T
Fukui
Naoki
N
Kasuga
Toshiya
T
Aono
Masahiro
M
Sako
Junichi
J
Hara
Koichi
K
Yamanishi
Shintaro
S
Okada
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000097:blood; D005312:Fetal Blood / Q000821:virology*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D015654:Herpesvirus 6, Human / Q000235:genetics / Q000254:growth & development*; D006801:Humans; D015994:Incidence; D007223:Infant; D016133:Polymerase Chain Reaction; D019349:Roseolovirus Infections / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D015996:Survival Rate; D019172:Transplantation Conditioning / Q000379:methods; D014184:Transplantation, Homologous / Q000009:adverse effects / Q000276:immunology; D019562:Viral Load; D014775:Virus Activation
D004279:DNA, Viral