The impact of human herpesvirus 6B reactivation on early complications following allogeneic hematopoietic stem cell transplantation.
Although human herpesvirus 6 (HHV-6) has been considered an important opportunistic and potentially fatal pathogen for allogeneic hematopoietic stem cell transplantation (HSCT), the clinical significance of HHV-6 reactivation remains controversial. In this study, we monitored HHV-6 DNAemia in 72 consecutive allogeneic HSCT recipients by real-time quantitative polymerase chain reaction. A total of 680 peripheral blood specimens were collected from the recipients before HSCT or at weekly intervals after HSCT. As the predominant variant, HHV-6B was detectable at least once in 47.2% (34/72) of HSCT recipients on the median day 21 (range, 7-84 days); HHV-6A reactivation occurred in only 1 recipient (1.4%). Detectable HHV-6B reactivation was associated with increased probability of skin rash by day 30 after HSCT (hazard ratio [HR], 3.68; 95% confidence interval [CI], 1.24-10.92; P = .019), cytomegalovirus (CMV) antigenemia (HR, 2.35; 95%CI, 1.32-4.19; P = .004), and hemorrhagic cystitis (HC) (HR, 2.59; 95%CI, 0.96-6.98; P = .061) by day 100 after HSCT. Neutrophil and platelet engraftment, mortality for 100 days after HSCT were not affected by HHV-6B reactivation. In conclusion, HHV-6 reactivation is a common event, and this study demonstrates a correlation between HHV-6B infection and CMV reactivation, early rash, and possibly increased incidence of HC after transplantation.
Wang
Li-Ru
LR
Peking University Institute of Hematology, Peking University People's Hospital, Beijing, PR China.
Dong
Lu-Jia
LJ
Zhang
Mei-Jie
MJ
Lu
Dao-Pei
DP
D000293:Adolescent; D000328:Adult; D002648:Child; D003556:Cystitis / Q000209:etiology* / Q000821:virology; D003586:Cytomegalovirus Infections / Q000150:complications*; D004279:DNA, Viral / Q000097:blood; D005076:Exanthema / Q000209:etiology; D005260:Female; D006085:Graft Survival; D019337:Hematologic Neoplasms / Q000150:complications / Q000601:surgery; D006470:Hemorrhage / Q000209:etiology* / Q000821:virology; D015654:Herpesvirus 6, Human / Q000302:isolation & purification / Q000502:physiology*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation; D011183:Postoperative Complications / Q000209:etiology* / Q000821:virology; D020133:Reverse Transcriptase Polymerase Chain Reaction; D019349:Roseolovirus Infections / Q000150:complications* / Q000821:virology; D012640:Seizures / Q000209:etiology; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D014766:Viremia / Q000150:complications* / Q000821:virology; D014775:Virus Activation
D004279:DNA, Viral