Risk factors for developing human herpesvirus 6 (HHV-6) reactivation after allogeneic hematopoietic stem cell transplantation and its association with central nervous system disorders.
We prospectively evaluated the incidence of human herpesvirus 6 (HHV-6) DNAemia after allogeneic hematopoietic stem cell transplantation (HSCT) using quantitative plasma real-time polymerase chain reaction. Of 46 recipients of bone marrow or peripheral blood stem cell transplantation (BMT/PBSCT) from related (n = 11) or unrelated donors (n = 22), and cord blood transplantation (CBT) from unrelated donors (n = 13), 22 (47.8%) developed HHV-6 DNAemia. HHV-6 DNA levels ranged from 200 to 200,000 copies/mL of plasma, and HHV-6 DNAemia was observed significantly more frequently after CBT than after BMT/PBSCT (92.3% vs 30.3%; P < .001). Multivariate analyses identified CBT (vs BMT/PBSCT), HLA mismatches between recipient and donor, and low anti-HHV-6 IgG titer before transplantation as the only risk factors for developing HHV-6 DNAemia. Three patients developed central nervous system (CNS) disorders with detectable HHV-6 DNA in the cerebrospinal fluid; all of these patients simultaneously developed HHV-6 DNAemia. These results suggest that HHV-6 DNAemia is frequently observed after allogeneic HSCT, especially in patients with the aforementioned risk factors. Thus, together with the assessment of risk factors, monitoring of HHV-6 DNAemia could be a useful asset in diagnosing HHV-6-associated CNS disorders.
Yamane
Akiko
A
Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
Mori
Takehiko
T
Suzuki
Shigeaki
S
Mihara
Ai
A
Yamazaki
Rie
R
Aisa
Yoshinobu
Y
Nakazato
Tomonori
T
Shimizu
Takayuki
T
Ikeda
Yasuo
Y
Okamoto
Shinichiro
S
D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D002493:Central Nervous System Diseases / Q000821:virology*; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects*; D004279:DNA, Viral / Q000097:blood / Q000134:cerebrospinal fluid; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D015654:Herpesvirus 6, Human / Q000276:immunology*; D006650:Histocompatibility Testing / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012307:Risk Factors; D019349:Roseolovirus Infections / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D055502:Secondary Prevention; D014766:Viremia / Q000209:etiology
D004279:DNA, Viral