Human herpesvirus 6 antigenaemia in allogeneic stem cell transplant recipients: impact on clinical course and association with other beta-herpesviruses.
Human herpesvirus 6 (HHV-6) antigenaemia was prospectively studied in 58 adult allogeneic stem cell transplant (SCT) recipients. Altogether 42 of 58 recipients (72%) demonstrated HHV-6 specific antigens in peripheral blood mononuclear cells after SCT, 22 of 36 (61%) when the donor was a sibling and 20 of 22 (91%) when the donor was unrelated. The cumulative incidence of HHV-6A, HHV-6B, HHV-7, and cytomegalovirus antigenaemia during the first 6 months after SCT was 33%, 62%, 44% and 63% respectively. The median day of the onset of each antigenaemia was +24, +4, +59, and +46 after SCT respectively. There were no clinical findings related to HHV-6A and HHV-7 antigenaemias. A rash was diagnosed in 10 of 38 (26%) HHV-6B antigenaemia positive patients during the first month after SCT compared with one of 20 (5%) HHV-6B negative patients. Of the HHV-6B antigenaemia cases, six of 10 rashes were treated as acute graft-versus-host disease (GVHD) and four of 10 were considered to be of a viral origin. Fifteen patients had acute GVHD diagnosed. Acute GVHD manifested statistically significantly (P = 0.034) earlier in the nine patients with HHV-6B antigenaemia compared with the six patients who were HHV-6B negative.
Department of Medicine, Helsinki University Central Hospital, PO Box 340, FIN-00029 HUS, Helsinki, Finland. liisa.volin@hus.fi
Liisa
L
Volin
Irmeli
I
Lautenschlager
Eeva
E
Juvonen
Anne
A
Nihtinen
Veli-Jukka
VJ
Anttila
Tapani
T
Ruutu
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000956:Antigens, Viral / Q000097:blood*; D016009:Chi-Square Distribution; D003587:Cytomegalovirus / Q000276:immunology; D005260:Female; D006086:Graft vs Host Disease / Q000276:immunology; D015654:Herpesvirus 6, Human / Q000276:immunology*; D016199:Herpesvirus 7, Human / Q000276:immunology; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D033581:Stem Cell Transplantation; D014184:Transplantation, Homologous; D014777:Virus Diseases / Q000276:immunology*
D000956:Antigens, Viral