Human herpesvirus 6 infection in hematopoietic stem cell transplant patients

Yoshikawa, Tetsushi

doi:10.1046/j.1365-2141.2003.04788.x

Cited by 80 publications

(63 citation statements)

References 140 publications

(182 reference statements)

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“…It is well known that HHV-6 reactivation generally occurs between 2 and 4 weeks after transplantation, 5,6,8,14,18,21,26 and this study further supports these findings. However, the mechanism of HHV-6 reactivation remains unclear.…”

Section: Discussionsupporting

confidence: 88%

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Human herpesvirus 6 infection in adult living related liver transplant recipients

et al. 2007

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To analyze human herpesvirus 6 (HHV-6) infection in adult living related liver transplantation, we performed a virological analysis, including viral isolation, serological assay, and real-time polymerase chain reaction, of serially collected blood samples from 67 recipients. In addition, cytokine levels were measured to determine their role in viral reactivation. HHV-6 was isolated from only 4 recipients (6.0%), and viral DNA was detected in 15 (22.4%) of the 67 recipients. A significant increase in HHV-6 immunoglobulin G antibody titers was observed in 19 (28.4%) of the 67 recipients. Finally, 26 recipients (38.8%) had HHV-6 reactivation 2-6 weeks after transplantation. HHV-6 associated clinical features were analyzed in the 17 recipients presenting with either viremia or DNAemia. Two recipients with viremia and 3 recipients with DNAemia had unexplained fever at the time of viral infection. An increase in aminotransferase levels was observed in 2 recipients with viremia and 3 recipients with DNAemia. Recipients with liver cirrhosis caused by hepatitis B virus or hepatitis C virus infection as the underlying disease were more likely to have HHV-6 infection (P ϭ 0.025). Mortality at the last follow-up in recipients with HHV-6 reactivation was significantly higher than in those without viral reactivation (P ϭ 0.0118). Plasma interleukin-6 levels were significantly higher in the recipients with HHV-6 viremia than in the recipients without viremia at 4 weeks post-transplant (P ϭ 0.0411). Moreover, tumor necrosis factor ␣ levels were also higher in recipients with HHV-6 viremia (P Ͻ 0.0001) or reactivation (P ϭ 0.0011) than in recipients without viremia or reactivation 4 weeks post-transplant.

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Section: Discussionsupporting

confidence: 88%

“…5,6,8,14,18,21,26 However, the mechanism of viral reactivation in liver transplant recipients remains unclear. HHV-6 belongs to the ␤-herpesvirinae subfamily, which also includes the human herpesviruses CMV and HHV-7.…”

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confidence: 99%

Human herpesvirus 6 infection in adult living related liver transplant recipients

et al. 2007

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“…If anti-CD46 antibodies may be envisaged, 38 other therapeutic agents are already available in prophylaxis such as ganciclovir or foscarnet. 39 Finally, two cases consistent with chromosomally integrated HHV6 were also observed, which is in accordance with the prevalence of 0.2-0.8% observed in the general population. 40,41 In conclusion, our results show that after allo-HSCT, the pattern of HHV6 infection is dependent on the source of SCs.…”

Section: Discussionsupporting

confidence: 73%

Human herpes virus 6 infection is a hallmark of cord blood transplant in adults and may participate to delayed engraftment: a comparison with matched unrelated donors as stem cell source

Chevallier

Hebia-Fellah²,

Planche

et al. 2009

Bone Marrow Transplant

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Occurrence of CMV, EBV and human herpes virus 6 (HHV6) infections and immune reconstitution were compared in 15 adult patients receiving a cord blood transplantation (CBT) and 40 patients who received an allogeneic transplantation from a matched unrelated donor (MUD). Herpes virus DNA quantifications in the blood (459 samples) were performed before and then monthly up to 9 months after transplant and the main lymphocytes populations were counted at 3, 6 and 9 months. Incidence of HHV6 infection was significantly higher in the CBT group (80 vs 42.5%; Po0.0001), with higher viral load (Po0.0001). In multivariate analysis, the use of a CBT and a myeloablative conditioning regimen were found to increase the risk of HHV6 infection (odds ratio (OR) ¼ 5.4, P ¼ 0.02 and OR ¼ 3.5, P ¼ 0.04, respectively). Incidences of CMV were similar between the two groups whereas MUD increased the risk of EBV infection, in univariate analysis only. HHV6 reactivation translated toward delayed neutrophils and plts engraftment in the two groups. MUD and CBT do not share the same immune reconstitution patterns, notably for B and CD8 lymphocytes and NK cells. There is a strong and specific relationship between HHV6 infection and the use of cord blood cells.

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“…However, previous studies have shown that detection of HHV-6 DNA in serum or plasma is a useful marker of active infection. 2,5,6 Thus, fever, skin rash, and liver dysfunction in our patient were considered to be associated with HHV-6A infection. This is the first report studying the incidence and the clinical features of HHV-6A infection in the early period after CBT.…”

mentioning

confidence: 99%

Human herpesvirus 6 variant A infection with fever, skin rash, and liver dysfunction in a patient after unrelated cord blood transplantation

Tomonari

Takahashi

Ooi

et al. 2005

Bone Marrow Transplant

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Human herpesvirus 6 infection in hematopoietic stem cell transplant patients

Cited by 80 publications

References 140 publications

Human herpesvirus 6 infection in adult living related liver transplant recipients

Human herpesvirus 6 infection in adult living related liver transplant recipients

Human herpes virus 6 infection is a hallmark of cord blood transplant in adults and may participate to delayed engraftment: a comparison with matched unrelated donors as stem cell source

Human herpesvirus 6 variant A infection with fever, skin rash, and liver dysfunction in a patient after unrelated cord blood transplantation

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