Risk factors for human herpesvirus 6 reactivation and its relationship with syndrome of inappropriate antidiuretic hormone secretion after stem cell transplantation in pediatric patients.
There have been several reports on the reactivation of human herpesvirus 6 (HHV6) after stem cell transplantation (SCT) in adults, which sometimes induces severe illness. Few reports exist on pediatric patients; therefore, we retrospectively examined HHV6 reactivation after SCT in children. We reviewed 80 patients with a median age of 6 years. We analyzed HHV6 DNA serum samples from the patients before SCT and at 20 and 40 days after SCT using polymerase chain reaction. We also analyzed the relationship between HHV6 reactivation and the syndrome of inappropriate antidiuretic hormone secretion (SIADH). At 20 days after SCT, 35.0% of serum samples were positive for HHV6 DNA. The median viral load was 3.1×10 copies/mL serum. Multivariate analysis showed cord blood transplantation as the only risk factor for HHV6 reactivation. HHV6 reactivation occurs in 59.4% of 32 patients who underwent cord blood transplantation and in 18.8% of 48 patients who underwent SCT from other sources. Among the 14 patients with SIADH, 78.6% experienced HHV6 reactivation. Among the 66 patients without SIADH, only 25.8% had HHV6 reactivation. This result was statistically significant (P<0.001). This analysis revealed that HHV6 reactivation occurs in many children. In addition, HHV6 reactivation plus SIADH should prompt evaluation for central nervous system disease.
*Department of Pediatrics, Asahikawa Medical University †Department of Pediatrics, Sapporo Hokuyu Hospital ‡Department of Pediatrics, Hokkaido University Graduate School of Medicine, Hokkaido §Department of Hematology, Oita University Faculty of Medicine, Oita, Japan.
Naohisa
N
Toriumi
Ryoji
R
Kobayashi
Makoto
M
Yoshida
Akihiro
A
Iguchi
Takeo
T
Sarashina
Hitoshi
H
Okubo
Daisuke
D
Suzuki
Hirozumi
H
Sano
Masao
M
Ogata
Hiroshi
H
Azuma
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D019337:Hematologic Neoplasms / Q000150:complications* / Q000628:therapy / Q000821:virology; D015654:Herpesvirus 6, Human / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity*; D006801:Humans; D007177:Inappropriate ADH Syndrome / Q000150:complications*; D007223:Infant; D008297:Male; D016133:Polymerase Chain Reaction; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D019349:Roseolovirus Infections / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D033581:Stem Cell Transplantation / Q000009:adverse effects*; D015996:Survival Rate; D019562:Viral Load; D014775:Virus Activation; D055815:Young Adult
D004279:DNA, Viral