PMID- 15824982
OWN - NLM
STAT- MEDLINE
DCOM- 20060724
LR  - 20160422
IS  - 1537-6591 (Electronic)
IS  - 1058-4838 (Linking)
VI  - 40
IP  - 7
DP  - 2005 Apr 1
TI  - Clinical outcomes of human herpesvirus 6 reactivation after hematopoietic stem 
      cell transplantation.
PG  - 932-40
AB  - BACKGROUND: Although human herpesvirus 6 (HHV-6) is known to reactivate during 
      hematopoietic stem cell transplantation (HSCT), the clinical significance of this 
      finding is controversial. METHODS: We used a quantitative PCR test for HHV-6 to 
      assay plasma samples prospectively collected from a cohort of 110 allogeneic HSCT 
      recipients to evaluate the clinical effects of HHV-6 infection. A retrospective 
      review of medical records was performed to determine clinical end points. 
      RESULTS: HHV-6 reactivation occurred in 52 (47%) of the 110 subjects. Factors 
      that increased the risk of subsequent HHV-6 reactivation were hematologic 
      malignancy that occurred at a time other than the first remission (adjusted P = 
      .002), a mismatch in the sexes of donor and recipient (adjusted P=.05), younger 
      age (adjusted P = .01), and the receipt of glucocorticoids (adjusted P = .06). 
      HHV-6 reactivation was associated with subsequent all-cause mortality (adjusted 
      hazard ration [HR], 2.9; 95% confidence interval [CI], 1.1-7.5), grade 3-4 
      graft-versus-host disease (GVHD) (adjusted HR, 4.9; 95% CI, 1.5-16), a lower 
      probability of monocyte engraftment (adjusted HR, 0.42; 95% CI; 0.22-0.80), a 
      lower probability of platelet engraftment (adjusted HR, 0.47; 95% CI, 0.21-1.1; P 
      = .05) and a higher platelet transfusion requirement (adjusted P = .02). A higher 
      level of HHV-6 DNA was associated with subsequent central nervous system (CNS) 
      dysfunction (HR, 21; 95% CI, 1.8-249). CONCLUSIONS: HHV-6 reactivation is common 
      after allogeneic HSCT and is associated with subsequent delayed monocyte and 
      platelet engraftment, increased platelet transfusion requirements, all-cause 
      mortality, grade 3-4 GVHD, and CNS dysfunction.
FAU - Zerr, Danielle M
AU  - Zerr DM
AD  - Department of Pediatrics, University of Washington, Seattle, Washington, USA. 
      zerr@u.washington.edu
FAU - Corey, Lawrence
AU  - Corey L
FAU - Kim, Hyung W
AU  - Kim HW
FAU - Huang, Meei-Li
AU  - Huang ML
FAU - Nguy, Long
AU  - Nguy L
FAU - Boeckh, Michael
AU  - Boeckh M
LA  - eng
GR  - AI01679/AI/NIAID NIH HHS/United States
GR  - CA 15704/CA/NCI NIH HHS/United States
GR  - CA 18029/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, U.S. Gov't, P.H.S.
DEP - 20050302
PL  - United States
TA  - Clin Infect Dis
JT  - Clinical infectious diseases : an official publication of the Infectious Diseases 
      Society of America
JID - 9203213
RN  - 0 (DNA, Viral)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Cohort Studies
MH  - DNA, Viral/blood
MH  - Female
MH  - Hematopoietic Stem Cell Transplantation/*adverse effects
MH  - Herpesvirus 6, Human/*isolation & purification
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Platelet Transfusion
MH  - Risk Factors
MH  - Roseolovirus Infections/etiology/*virology
MH  - Time Factors
MH  - *Virus Activation
EDAT- 2005/04/13 09:00
MHDA- 2006/07/25 09:00
CRDT- 2005/04/13 09:00
PHST- 2004/09/20 00:00 [received]
PHST- 2004/10/28 00:00 [accepted]
PHST- 2005/04/13 09:00 [pubmed]
PHST- 2006/07/25 09:00 [medline]
PHST- 2005/04/13 09:00 [entrez]
AID - CID34999 [pii]
AID - 10.1086/428060 [doi]
PST - ppublish
SO  - Clin Infect Dis. 2005 Apr 1;40(7):932-40. doi: 10.1086/428060. Epub 2005 Mar 2.