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Sixteen adults were studied for the first 100 days after allogeneic bone marrow transplant to assess the pathogenic role of human herpesvirus-6 (HHV-6) infection in patients with unexplained febrile illnesses. HHV-6 was directly isolated from the blood of 6 patients. Analysis of the clinical courses of these 16 patients revealed otherwise unexplained posttransplant marrow suppression in 5 patients. Idiopathic marrow suppression occurred more frequently in patients with concurrent HHV-6 viremia (4/6) than in those from whom HHV-6 was not isolated from peripheral blood (1/10, P < .05). An etiologic role for the virus was also supported by isolation of HHV-6 from the bone marrow of all 4 patients at the time of marrow suppression and by in vitro colony-forming unit (cfu) assays that demonstrated that HHV-6 could inhibit cfu-granulocyte-macrophage and burst-forming unit-erythroid growth from human bone marrow. By restriction enzyme mapping, all clinical isolates were type B, suggesting that bone marrow transplant recipients may be preferentially infected with and reactivate this HHV-6 subtype. This study implicates HHV-6 as a novel cause of bone marrow suppression in marrow transplant recipients.

*Members of the gammaretroviruses-such as murine leukemia viruses (MLVs), most notably XMRV [xenotropic murine leukemia virus (X-MLV)-related virus-have been reported to be present in the blood of patients with chronic fatigue syndrome (CFS). We evaluated blood samples from 61 patients with CFS from a single clinical practice, 43 of whom had previously been identified as XMRV-positive. Our analysis included polymerase chain reaction and reverse transcription polymerase chain reaction procedures for detection of viral nucleic acids and assays for detection of infectious virus and virus-specific antibodies. We found no evidence of XMRV or other MLVs in these blood samples. In addition, we found that these gammaretroviruses were strongly (X-MLV) or partially (XMRV) susceptible to inactivation by sera from CFS patients and healthy controls, which suggested that establishment of a successful MLV infection in humans would be unlikely. Consistent with previous reports, we detected MLV sequences in commercial laboratory reagents. Our results indicate that previous evidence linking XMRV and MLVs to CFS is likely attributable to laboratory contamination. X enotropic retroviruses, first discovered in mice, have the unusual characteristic of being endogenous to animal species, i.e., integrated into the animal's genome, but not able to reinfect cells from that species. However, as the name (xenos, foreign) implies, these viruses can infect cells from other animal species. The xenotropic murine leukemia virus (X-MLV), for example, infects cells from several species including humans but cannot infect many mouse cells (1-3). One particular virus within this group, XMRV (xenotropic murine leukemia virus-related virus), was reported to be present in a subset of human prostate tumors (4) and in blood samples from patients with chronic fatigue syndrome (CFS) (5). Other murine-related gammaretroviruses have also reportedly been detected in CFS patients (6). The infection of humans with these viruses is controversial. Investigators evaluating independent cohorts of CFS patients have failed to detect XMRVor other MLVs (7-12), and contamination of human clinical material (13,14) and reagents (e.g., Taq polymerase) (15) with mouse DNA containing MLV-like sequences has been reported.To investigate these discrepancies in a more direct manner, we performed an extensive virological evaluation of blood samples from two human populations with a clinical diagnosis of CFS (16), many of whom had been diagnosed previously as XMRV-infected. The first (P1) consisted of 41 CFS patients ranging in age from 5 to 73 years who came from a private medical practice (Sierra Internal Medicine, Incline Village, Nevada). Twenty-six of the CFS subjects (63%) were female, and 15 (37%) were male; the female median age was 52 years (range 5 to 72 years), and the male median age was 49 years (range 20 to 73 years). These patients were an unselected, sequentially enrolled population submitted for diagnostic testing to the Wisconsin Viral Research Group (WVRG) and w...