PMID- 34111575
OWN - NLM
STAT- MEDLINE
DCOM- 20211014
LR  - 20220902
IS  - 2666-6367 (Electronic)
IS  - 2666-6375 (Print)
IS  - 2666-6367 (Linking)
VI  - 27
IP  - 9
DP  - 2021 Sep
TI  - Association of Inherited Chromosomally Integrated Human Herpesvirus 6 with 
      Neurologic Symptoms and Management after Allogeneic Hematopoietic Cell 
      Transplantation.
PG  - 795.e1-795.e8
LID - S2666-6367(21)00948-9 [pii]
LID - 10.1016/j.jtct.2021.05.029 [doi]
AB  - Reactivation of human herpesvirus 6 (HHV-6) after allogeneic hematopoietic cell 
      transplantation (HCT) is associated with neurologic complications, but the impact 
      of donor and/or recipient inherited chromosomally integrated HHV-6 (iciHHV-6) on 
      post-HCT central nervous system (CNS) symptoms and diagnostic and therapeutic 
      interventions is not well understood. The aims of the present study were (1) to 
      compare the cumulative incidence of CNS symptoms in the first 100 days following 
      allogeneic HCT among patients with donor and/or recipient iciHHV-6 
      (iciHHV-6(pos))with that of patients with neither donor nor recipient iciHHV-6 
      (iciHHV-6(neg)) and (2) to assess the role of HHV-6 detection in driving 
      potentially unnecessary interventions in iciHHV-6(pos) patients. We performed a 
      retrospective matched cohort study of 87 iciHHV-6(pos) and 174 iciHHV-6(neg) 
      allogeneic HCT recipients. HHV-6 testing was performed at the discretion of 
      healthcare providers, who were unaware of iciHHV-6 status. The cumulative 
      incidence of CNS symptoms was similar in iciHHV-6(pos) (n = 37; 43%) and 
      iciHHV-6(neg) HCT recipients (n = 81; 47%; P = .63). HHV-6 plasma testing was 
      performed in similar proportions of iciHHV-6(pos) (n = 6; 7%) and iciHHV-6(neg) 
      (9%) patients and was detected in all tested iciHHV-6(pos) HCTs and 2 (13%) 
      iciHHV-6(neg) HCTs. This resulted in more frequent HHV-6-targeted antiviral 
      therapy after iciHHV-6(pos) HCT (odds ratio, 12.8; 95% confidence interval, 1.5 
      to 108.2) with associated side effects. HHV-6 plasma detection in 2 iciHHV-6(pos) 
      patients without active CNS symptoms prompted unnecessary lumbar punctures. The 
      cumulative incidence of CNS symptoms was similar after allogeneic HCT involving 
      recipients or donors with and without iciHHV-6. Misattribution of HHV-6 detection 
      as infection after iciHHV-6(pos) HCT may lead to unnecessary interventions. 
      Testing for iciHHV-6 may improve patient management.
CI  - Copyright (c) 2021 The American Society for Transplantation and Cellular Therapy. 
      Published by Elsevier Inc. All rights reserved.
FAU - Heldman, Madeleine R
AU  - Heldman MR
AD  - Fred Hutchinson Cancer Research Center, Vaccine and Infectious Disease Division, 
      Seattle, Washington; Division of Allergy and Infectious Diseases, Department of 
      Medicine, University of Washington, Seattle, Washington. Electronic address: 
      mrh157@uw.edu.
FAU - Job, Cassandra
AU  - Job C
AD  - Fred Hutchinson Cancer Research Center, Vaccine and Infectious Disease Division, 
      Seattle, Washington.
FAU - Maalouf, Joyce
AU  - Maalouf J
AD  - Fred Hutchinson Cancer Research Center, Vaccine and Infectious Disease Division, 
      Seattle, Washington.
FAU - Morris, Jessica
AU  - Morris J
AD  - Fred Hutchinson Cancer Research Center, Vaccine and Infectious Disease Division, 
      Seattle, Washington.
FAU - Xie, Hu
AU  - Xie H
AD  - Fred Hutchinson Cancer Research Center, Vaccine and Infectious Disease Division, 
      Seattle, Washington.
FAU - Davis, Chris
AU  - Davis C
AD  - Fred Hutchinson Cancer Research Center, Vaccine and Infectious Disease Division, 
      Seattle, Washington.
FAU - Stevens-Ayers, Terry
AU  - Stevens-Ayers T
AD  - Fred Hutchinson Cancer Research Center, Vaccine and Infectious Disease Division, 
      Seattle, Washington.
FAU - Huang, Meei-Li
AU  - Huang ML
AD  - Fred Hutchinson Cancer Research Center, Vaccine and Infectious Disease Division, 
      Seattle, Washington; Department of Laboratory Medicine and Pathology, University 
      of Washington, Seattle, Washington.
FAU - Jerome, Keith R
AU  - Jerome KR
AD  - Fred Hutchinson Cancer Research Center, Vaccine and Infectious Disease Division, 
      Seattle, Washington; Department of Laboratory Medicine and Pathology, University 
      of Washington, Seattle, Washington.
FAU - Fann, Jesse R
AU  - Fann JR
AD  - Department of Psychiatry and Behavioral Sciences, University of Washington, 
      Seattle, Washington.
FAU - Zerr, Danielle M
AU  - Zerr DM
AD  - Fred Hutchinson Cancer Research Center, Vaccine and Infectious Disease Division, 
      Seattle, Washington; Department of Pediatrics, University of Washington, Seattle, 
      Washington.
FAU - Boeckh, Michael
AU  - Boeckh M
AD  - Fred Hutchinson Cancer Research Center, Vaccine and Infectious Disease Division, 
      Seattle, Washington; Division of Allergy and Infectious Diseases, Department of 
      Medicine, University of Washington, Seattle, Washington.
FAU - Hill, Joshua A
AU  - Hill JA
AD  - Fred Hutchinson Cancer Research Center, Vaccine and Infectious Disease Division, 
      Seattle, Washington; Division of Allergy and Infectious Diseases, Department of 
      Medicine, University of Washington, Seattle, Washington. Electronic address: 
      jahill3@fredhutch.org.
LA  - eng
GR  - T32 AI118690/AI/NIAID NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20210607
PL  - United States
TA  - Transplant Cell Ther
JT  - Transplantation and cellular therapy
JID - 101774629
SB  - IM
MH  - Cohort Studies
MH  - *Hematopoietic Stem Cell Transplantation/adverse effects
MH  - *Herpesvirus 6, Human/genetics
MH  - Humans
MH  - Retrospective Studies
MH  - Tissue Donors
PMC - PMC8403634
MID - NIHMS1712123
OTO - NOTNLM
OT  - Hematopoietic cell transplantation
OT  - Human herpesvirus 6
OT  - Immunocompromised
OT  - Inherited chromosomally integrated human herpesvirus 6
COIS- The other authors have no relevant interests to disclose.
EDAT- 2021/06/11 06:00
MHDA- 2021/10/15 06:00
PMCR- 2022/09/01
CRDT- 2021/06/10 20:13
PHST- 2021/03/22 00:00 [received]
PHST- 2021/05/19 00:00 [revised]
PHST- 2021/05/31 00:00 [accepted]
PHST- 2021/06/11 06:00 [pubmed]
PHST- 2021/10/15 06:00 [medline]
PHST- 2021/06/10 20:13 [entrez]
PHST- 2022/09/01 00:00 [pmc-release]
AID - S2666-6367(21)00948-9 [pii]
AID - 10.1016/j.jtct.2021.05.029 [doi]
PST - ppublish
SO  - Transplant Cell Ther. 2021 Sep;27(9):795.e1-795.e8. doi: 
      10.1016/j.jtct.2021.05.029. Epub 2021 Jun 7.