Human Herpesvirus 6 Infections after Bone Marrow Transplantation: Clinical and Virologic Manifestations

• Published in: The Journal of infectious diseases Vol. 179; no. 2; pp. 311 - 318
• Main Authors: Cone, Richard W., Huang, Meei-Li W., Corey, Lawrence, Zeh, Judith, Ashley, Rhoda, Bowden, Raleigh
• Format: Journal Article
• Language: English
• Published: Chicago, IL University Chicago Press 01.02.1999; University of Chicago Press; Oxford University Press
• Subjects: Adult; Antibodies; Biological and medical sciences; Blood; Bone marrow; Bone Marrow Transplantation - adverse effects; Cohort Studies; Cytomegalovirus - immunology; DNA, Viral - blood; Exanthema; Exanthema - etiology; Female; Fever - etiology; Herpesviridae; Herpesviridae Infections - etiology; Herpesviridae Infections - virology; Herpesvirus 6, Human; Human herpesvirus 6; Human viral diseases; Humans; Infections; Infectious diseases; Major Articles; Male; Medical sciences; Middle Aged; Polymerase chain reaction; Prospective Studies; Saliva; Transplantation; Transplantation, Homologous; Viral diseases; Viral diseases with cutaneous or mucosal lesions and viral diseases of the eye; Virus Activation; Human; Reactivation; Herpesviridae; Recipient; Serology; Betaherpesvirinae; Allogeneic system; Human cytomegalovirus; Infection; Virus; Herpesvirus hominis 6; Donor; Follow up study; Viral disease; Bone marrow; Complication; Graft; Seronegativity; Viral load; Quantitative analysis
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/314581

Human herpesvirus 6 (HHV-6) DNA levels in peripheral blood mononuclear cells were prospectively evaluated in 20 cytomegalovirus-seronegative allogeneic marrow transplant patients and in 10 healthy control subjects. Blood and saliva specimens obtained weekly for 3 months after transplant were evaluated by quantitative HHV-6 polymerase chain reaction. One of 20 patients experienced primary HHV-6 infection after marrow transplant (serocon-version, HHV-6 viremia, skin rash); 18 of 20 had increased peripheral blood mononuclear cell HHV-6 DNA levels consistent with asymptomatic reactivations, and 1 patient experienced a reactivation-associated skin rash. Genotyping revealed HHV-6 variant B DNA in all cases. Therapy with acyclovir or intravenous immunoglobulin was not correlated with lower HHV-6 DNA levels. Thus, asymptomatic HHV-6 reactivations appear to be common following allogeneic marrow transplantation. Among HHV-6-seronegative and viral DNA-negative patients, primary HHV-6 infection can ensue in association with self-limited clinical symptoms, including diffuse maculopapular rash.