Human herpesvirus-6 viremia is not associated with poor clinical outcomes in children following allogeneic hematopoietic cell transplantation.
HHV-6 is an evolving pathogen in the field of AlloHCT. However, the impact of HHV-6 on AlloHCT outcomes remains to be elucidated. We studied the incidence and clinical impact of HHV-6 viremia in children following AlloHCT. One hundred consecutive children were monitored weekly by plasma PCR for the first 180 days following AlloHCT for HHV-6, CMV, EBV, and ADV. HHV-6 viremia was defined as plasma PCR >1000 viral copies/mL. The median age was nine yr. Following AlloHCT, 19% (95% CI 11.3-26.7%) of patients had HHV-6 viremia, with the highest incidence of reactivation (14/19, 73%) occurring during day +15-day +98. The proportion of platelet engraftment by day +180 was lower in patients with HHV-6 viremia (58%) than in those without HHV-6 viremia (82%), p = 0.028. Delay in neutrophil and platelet engraftment was not associated with HHV-6 viremia in multivariate analysis. Similarly, HHV-6 viremia was not associated with TRM in multivariate analysis (p = 0.15). In summary, HHV-6 viremia is prevalent in pediatric AlloHCT recipients. Based on our study results, we recommend that HHV-6 PCR should only be performed on clinical suspicion.
Department of Nursing, New York-Presbyterian Morgan Stanley Children's Hospital, New York, NY, USA.
Leah
L
Violago
Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA.
Zhezhen
Z
Jin
Department of Pediatrics, Columbia University, New York, NY, USA.
Monica
M
Bhatia
Department of Pediatrics, Columbia University, New York, NY, USA.
Evelyn
E
Rustia
Department of Pediatrics, Columbia University, New York, NY, USA.
Andrew L
AL
Kung
Department of Pediatrics, Columbia University, New York, NY, USA.
Marc D
MD
Foca
Department of Pediatrics, Columbia University, New York, NY, USA.
Diane
D
George
Department of Pediatrics, Columbia University, New York, NY, USA.
James H
JH
Garvin
Department of Pediatrics, Columbia University, New York, NY, USA.
Jean
J
Sosna
Department of Pediatrics, Columbia University, New York, NY, USA.
Chalitha
C
Robinson
Department of Pediatrics, Columbia University, New York, NY, USA.
Esra
E
Karamehmet
Department of Pediatrics, Columbia University, New York, NY, USA.
Prakash
P
Satwani
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D051799:Delayed Graft Function / Q000821:virology; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D015654:Herpesvirus 6, Human / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D019349:Roseolovirus Infections / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D014184:Transplantation, Homologous; D014766:Viremia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult
hematopoietic stem cell transplant; human herpesvirus; pediatrics