PMID- 23723198
OWN - NLM
STAT- MEDLINE
DCOM- 20140310
LR  - 20220408
IS  - 1537-6591 (Electronic)
IS  - 1058-4838 (Linking)
VI  - 57
IP  - 5
DP  - 2013 Sep
TI  - Human herpesvirus 6 (HHV-6) reactivation and HHV-6 encephalitis after allogeneic 
      hematopoietic cell transplantation: a multicenter, prospective study.
PG  - 671-81
LID - 10.1093/cid/cit358 [doi]
AB  - BACKGROUND: The epidemiology of human herpesvirus 6 (HHV-6) encephalitis after 
      allogeneic hematopoietic cell transplantation (HCT) and its relationship with 
      HHV-6 reactivation have not been sufficiently characterized. METHODS: This 
      prospective, multicenter study of 230 allogeneic HCT recipients investigated the 
      epidemiology of HHV-6 reactivation and HHV-6 encephalitis. Plasma HHV-6 DNA load 
      was prospectively evaluated twice weekly until 70 days after HCT. RESULTS: 
      Cumulative incidence of positive HHV-6 DNA and high-level HHV-6 reactivation 
      (plasma HHV-6 DNA >/=10(4) copies/mL) at day 70 after HCT was 72.2% and 37.0%, 
      respectively. Multivariate analysis identified myeloablative conditioning (hazard 
      ratio [HR], 1.9; P = .004), umbilical cord blood transplantation (UCBT) (HR, 2.0; 
      P = .003), and male sex (HR, 1.6; P = .04) as risk factors for displaying 
      high-level HHV-6 reactivation. HHV-6 encephalitis occurred in 7 patients, and 
      cumulative incidence at day 70 was 3.0%. None of the144 patients without 
      high-level HHV-6 reactivation and 7 of 86 patients (8.1%) with high-level HHV-6 
      reactivation developed HHV-6 encephalitis (P = .0009). Prevalence of HHV-6 
      encephalitis was significantly higher among patients receiving UCBT than in 
      patients with other sources (cumulative incidence at day 70, 7.9% vs 1.2%, P = 
      .008). In each of 7 patients with HHV-6 encephalitis, central nervous system 
      (CNS) symptoms developed concomitant with peak plasma HHV-6 DNA (range, 21 
      656-433 639 copies/mL). CONCLUSIONS: High levels of plasma HHV-6 DNA are 
      associated with higher risk of HHV-6 encephalitis. UCBT is a significant risk 
      factor for HHV-6 encephalitis. HHV-6 encephalitis should be considered if CNS 
      dysfunction develops concomitant to high-level plasma HHV-6 DNA after allogeneic 
      HCT.
FAU - Ogata, Masao
AU  - Ogata M
AD  - Department of Hematology, Oita University Hospital, Hasama-machi, Yufu-city 
      879-5593, Japan. mogata@oita-u.ac.jp
FAU - Satou, Takako
AU  - Satou T
FAU - Kadota, Jun-ichi
AU  - Kadota J
FAU - Saito, Noriyuki
AU  - Saito N
FAU - Yoshida, Takashi
AU  - Yoshida T
FAU - Okumura, Hirokazu
AU  - Okumura H
FAU - Ueki, Toshimitsu
AU  - Ueki T
FAU - Nagafuji, Koji
AU  - Nagafuji K
FAU - Kako, Shinichi
AU  - Kako S
FAU - Uoshima, Nobuhiko
AU  - Uoshima N
FAU - Tsudo, Mitsuru
AU  - Tsudo M
FAU - Itamura, Hidekazu
AU  - Itamura H
FAU - Fukuda, Takahiro
AU  - Fukuda T
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20130530
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  - Cord Blood Stem Cell Transplantation/*adverse effects
MH  - DNA, Viral/blood
MH  - Encephalitis, Viral/*epidemiology/virology
MH  - Female
MH  - Herpesvirus 6, Human/*isolation & purification
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Roseolovirus Infections/*epidemiology/virology
MH  - Viral Load
MH  - *Virus Activation
MH  - Young Adult
OTO - NOTNLM
OT  - HHV-6 encephalitis
OT  - HHV-6 reactivation
OT  - allogeneic hematopoietic cell transplantation
OT  - human herpesvirus 6
OT  - viral load
EDAT- 2013/06/01 06:00
MHDA- 2014/03/13 06:00
CRDT- 2013/06/01 06:00
PHST- 2013/06/01 06:00 [entrez]
PHST- 2013/06/01 06:00 [pubmed]
PHST- 2014/03/13 06:00 [medline]
AID - cit358 [pii]
AID - 10.1093/cid/cit358 [doi]
PST - ppublish
SO  - Clin Infect Dis. 2013 Sep;57(5):671-81. doi: 10.1093/cid/cit358. Epub 2013 May 
      30.