Transmission of integrated human herpesvirus-6 in allogeneic hematopoietic stem cell transplantation

R. T. Kamble, D. A. Clark, H. N. Leong, H. E. Heslop, M. K. Brenner, G. Carrum

Research output: Contribution to journalArticle

47 Scopus citations

Abstract

Human herpesvirus 6 (HHV-6) viremia, as detected by polymerase chain amplification, occurs in approximately half of allogeneic hematopoietic stem cell transplant recipients. The significance of such viremia is incompletely understood, but HHV-6 encephalitis and bone marrow suppression are increasingly being recognized in patients with high viral DNA. We report two patients in whom donor-to-recipient transmission occurred through hematopoietic transplant by means of chromosomally integrated (CI) HHV-6. Iatrogenic transmission manifested at engraftment as asymptomatic elevation of HHV-6 viral DNA of 3600 and 15 400 DNA copies/ml in plasma and 6.1 × 106 and 9.7 × 105 DNA copies/ml in the whole blood. Both donors had elevated plasma HHV-6 PCR at 5.6 × 104 and 1.3 × 105 DNA copies/ml and strikingly elevated whole blood HHV-6 levels at 4.1 × 106 and 4.7 × 106 DNA copies/ml, respectively. CI of the virus was traced to the mother of one patient and his donor. CI of HHV-6 may confound the interpretation of HHV-6 viremia after stem cell transplantation; consideration of the possibility of CI HHV-6 will avoid unnecessary antiviral therapy.

Original languageEnglish (US)
Pages (from-to)563-566
Number of pages4
JournalBone Marrow Transplantation
Volume40
Issue number6
DOIs
StatePublished - Sep 2007

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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