Human herpes virus 6 reactivation following autologous hematopoietic cell transplantation - a single-center experience

Leuk Lymphoma. 2019 Sep;60(9):2230-2236. doi: 10.1080/10428194.2019.1576869. Epub 2019 Feb 18.

Abstract

Data regarding presentation and management of human herpes virus 6 (HHV-6) reactivation among autologous hematopoietic cell transplantation (HCT) recipients are limited. We retrospectively reviewed medical charts of all autologous HCT patients tested for HHV-6 reactivation due to suspected clinical presentation between 1/2012 and 8/2017. Among 328 autologous HCT recipients, 44 patients were tested for HHV-6 reactivation. Thirty patients tested positive; 29 (97%) had sustained fever, six (20%) had rash and four (13%) had pneumonia. Median C-reactive protein was significantly lower in HHV-6 positive patients compared to negative patients (3.6 (range, 0.4-11) vs. 9.6 (range, 3.2-30) mg/dL, respectively, p = .004). Ganciclovir formulations were administrated in 29 (97%) patients with median time to fever resolution of one (range, 1-2) day. HHV-6 should be considered as an important cause of post engraftment fever in autologous HCT. Larger studies are warranted to evaluate incidence of HHV-6 reactivation and optimal treatment regimen.

Keywords: Autologous; HHV-6; human herpes virus 6; transplantation.

MeSH terms

  • Adult
  • Aged
  • Antiviral Agents / therapeutic use
  • C-Reactive Protein / analysis
  • DNA, Viral / isolation & purification
  • Female
  • Fever / drug therapy
  • Fever / epidemiology*
  • Fever / immunology
  • Fever / virology
  • Ganciclovir / therapeutic use
  • Hematologic Neoplasms / immunology
  • Hematologic Neoplasms / surgery
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Herpesvirus 6, Human / genetics
  • Herpesvirus 6, Human / immunology
  • Herpesvirus 6, Human / isolation & purification*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Postoperative Complications / drug therapy
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / immunology
  • Postoperative Complications / virology
  • Retrospective Studies
  • Risk Factors
  • Roseolovirus Infections / drug therapy
  • Roseolovirus Infections / epidemiology*
  • Roseolovirus Infections / immunology
  • Roseolovirus Infections / virology
  • Transplantation, Autologous / adverse effects
  • Virus Activation / immunology

Substances

  • Antiviral Agents
  • DNA, Viral
  • C-Reactive Protein
  • Ganciclovir