Impact of human herpesvirus-6 after haematopoietic stem cell transplantation.
We studied 228 consecutive stem cell transplant recipients, screened for reactivation of human herpesvirus-6 (HHV-6) in peripheral blood and other specimens as clinically indicated by means of qualitative polymerase chain reaction. Among them, 197 received an allograft and 31 autograft. Ninety-six of 228 patients (42.1%) showed HHV-6 reactivation in peripheral blood and 129 of 228 (56.6%) demonstrated HHV-6 in at least one of the specimens tested. 41.9% of patients were asymptomatic when HHV-6 was identified. Clinical features, noted when HHV-6 was detected, included interstitial or alveolar pneumonia, gastroduodenal and colorectal disease, bone marrow suppression and liver disease. However, based on clinical and histopathological criteria, HHV-6 was considered a causal agent in only a minority of patients, in particular, those suffering from bone marrow suppression (n = 11), gastroduodenitis (five), colitis (three), interstitial/alveolar pneumonia (five), skin rash (one), pericarditis (two) and encephalitis (one). HHV-6 reactivation was significantly associated with the occurrence of graft-versus-host disease [odds ratio (OR) 5.31], Epstein-Barr virus coinfection (OR 8.89) and unrelated donor transplantation (OR 5.67) indicating an increased stage of immunosuppression.
Hentrich
Marcus
M
Department of Internal Medicine III, University Hospital Grosshadern, Germany.
Oruzio
Daniel
D
Jäger
Gundula
G
Schlemmer
Marcus
M
Schleuning
Michael
M
Schiel
Xaver
X
Hiddemann
Wolfgang
W
Kolb
Hans-Jochem
HJ
D000293:Adolescent; D000328:Adult; D004279:DNA, Viral / Q000032:analysis; D020031:Epstein-Barr Virus Infections / Q000150:complications; D005260:Female; D006086:Graft vs Host Disease; D018380:Hematopoietic Stem Cell Transplantation; D015654:Herpesvirus 6, Human / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods; D011184:Postoperative Period; D011446:Prospective Studies; D012307:Risk Factors; D019349:Roseolovirus Infections / Q000175:diagnosis*; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D014775:Virus Activation
D004279:DNA, Viral