Risk factors for developing human herpesvirus 6 (HHV-6) reactivation after allogeneic hematopoietic stem cell transplantation and its association with central nervous system disorders

Biol Blood Marrow Transplant. 2007 Jan;13(1):100-6. doi: 10.1016/j.bbmt.2006.09.003.

Abstract

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.

MeSH terms

  • Adult
  • Bone Marrow Transplantation / adverse effects
  • Central Nervous System Diseases / virology*
  • Cord Blood Stem Cell Transplantation / adverse effects*
  • DNA, Viral / blood
  • DNA, Viral / cerebrospinal fluid
  • Female
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Herpesvirus 6, Human / immunology*
  • Histocompatibility Testing / adverse effects
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Peripheral Blood Stem Cell Transplantation / adverse effects
  • Polymerase Chain Reaction
  • Prospective Studies
  • Risk Factors
  • Roseolovirus Infections / epidemiology
  • Roseolovirus Infections / etiology
  • Roseolovirus Infections / prevention & control*
  • Secondary Prevention
  • Viremia / etiology

Substances

  • DNA, Viral