1. Human herpesvirus 6: infection and disease following autologous and allogeneic bone marrow transplantation.
- Author
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Kadakia MP, Rybka WB, Stewart JA, Patton JL, Stamey FR, Elsawy M, Pellett PE, and Armstrong JA
- Subjects
- Adult, Base Sequence, Breast Neoplasms epidemiology, Breast Neoplasms therapy, Comorbidity, Cytomegalovirus Infections epidemiology, DNA, Viral analysis, Female, Graft vs Host Disease epidemiology, Herpes Zoster epidemiology, Herpesviridae Infections epidemiology, Herpesvirus 6, Human classification, Herpesvirus 6, Human physiology, Humans, Immunosuppression Therapy adverse effects, Infections epidemiology, Leukemia epidemiology, Leukemia therapy, Leukocytes, Mononuclear virology, Life Tables, Lymphoma epidemiology, Lymphoma therapy, Male, Middle Aged, Molecular Sequence Data, Ovarian Neoplasms epidemiology, Ovarian Neoplasms therapy, Pennsylvania epidemiology, Pilot Projects, Prospective Studies, Sinusitis epidemiology, Sinusitis virology, Survival Analysis, Transplantation, Autologous adverse effects, Transplantation, Homologous adverse effects, Treatment Outcome, Bone Marrow Transplantation adverse effects, Herpesviridae Infections etiology, Herpesvirus 6, Human isolation & purification, Virus Activation
- Abstract
Human herpesvirus 6 activity (HHV-6) was studied in 15 allogeneic and 11 autologous marrow transplantation patients. After transplantation, HHV-6 was isolated from the peripheral blood mononuclear cells of 12 of 26 patients (6 allogeneic and 6 autologous). All isolates were variant B. Eleven of 26 and 12 of 19 patients showed salivary shedding of HHV-6 DNA before and after transplantation, respectively. The antibody titer increased in 7 of 26 patients. Thus, 23 of 26 patients showed evidence of active HHV-6 infection either by virus isolation, salivary shedding, or increases in antibody titers. The fraction of saliva specimens positive in 19 patients was negatively associated with their antibody titers (P= .005). The proportion of cultures positive increased after transplantation (P = .007). Sinusitis was associated with HHV-6 isolation in autologous recipients (P= .002). In allogeneic patients, active human cytomegalovirus infection was associated with HHV-6 isolation (P = .04). No association was observed between HHV-6 infection and GVHD, pneumonia, delay in engraftment, or marrow suppression. Of the 120 clinical events analyzed in 26 patients, HHV-6 was defined as a probable cause of 16 events in 9 patients based on the propinquity of HHV-6 activity and the clinical event plus the absence of other identified causes of the event.
- Published
- 1996