High levels of human herpesvirus 6 DNA in peripheral blood leucocytes are correlated to platelet engraftment and disease in allogeneic stem cell transplant patients

• Published in: British journal of haematology Vol. 111; no. 3; pp. 774 - 781
• Main Authors: LJUNGMAN, P, WANG, F.-Z, CLARK, D. A, EMERY, V. C, REMBERGER, M, RINGDEN, O, LINDE, A
• Format: Journal Article
• Language: English
• Published: Oxford Blackwell 01-12-2000; Blackwell Publishing Ltd
• Subjects: Acyclovir - therapeutic use; Adolescent; Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Antiviral Agents - therapeutic use; Biological and medical sciences; Blood Platelets - virology; Bone Marrow Transplantation - adverse effects; Bone marrow, stem cells transplantation. Graft versus host reaction; Central Nervous System Diseases - virology; Child; Child, Preschool; Cytomegalovirus - genetics; DNA, Viral - analysis; Female; Graft vs Host Disease; Hematology; Hematopoietic Stem Cell Transplantation - adverse effects; Hepatitis - virology; Herpesviridae Infections - immunology; Herpesviridae Infections - prevention & control; Herpesviridae Infections - transmission; Herpesvirus 6, Human - genetics; Histocompatibility Testing; Humans; Immunoglobulins, Intravenous; Leukocytes - virology; Male; Medical sciences; Medicin och hälsovetenskap; Middle Aged; Multivariate Analysis; Platelet Transfusion; Polymerase Chain Reaction; Postoperative Period; Prospective Studies; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation, Homologous; Viral Load; Human; Encephalitis; Nervous system diseases; Prognosis; Leukocyte; Herpesviridae; Stem cell; Hematopoietic cell; Homograft; Transplantation; Multivariate analysis; Gene expression; Cerebral disorder; Virus; Polymerase chain reaction; Herpesvirus hominis 6; DNA; Central nervous system disease; Complication
• ISSN: 0007-1048; 1365-2141
• DOI: 10.1046/j.1365-2141.2000.02422.x

The aim of this study was to correlate human herpesvirus (HHV)-6 viral load with clinical symptoms in allogeneic stem cell transplant (SCT) patients. Seventy-four patients were monitored during the first 3 months after SCT using a qualitative polymerase chain reaction (PCR) for HHV-6 DNA. HHV-6 was detected in 181 out of 494 samples (36%) from 58 (78%) patients. These 181 samples were analysed using a quantitative competitive PCR. DNA could be quantified from 146 out of 181 samples (80.6%). The HHV-6 viral load was highest at 4 weeks compared with 8 weeks (P < 0.001) and 12 weeks (P = 0.01) after SCT. Three patients had HHV-6 encephalitis and one patient had hepatitis. The HHV-6 DNA levels were higher in patients with HHV-6 than in those without HHV-6 (P = 0.01). Patients who received grafts from unrelated or HLA-mismatched family donors had significantly higher HHV-6 DNA levels than patients who received grafts from matched sibling donors (P < 0.001). In a multiple regression model, unrelated donor grafts (P < 0.001) and use of intravenous immunoglobulin prophylaxis (P = 0.04) influenced HHV-6 DNA levels. HHV-6 viral load was significantly correlated with delayed platelet engraftment in both univariate (P < 0.01) and multivariate analysis, and to the number of platelet transfusions.