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Blood, 15 September 2002, Vol. 100, No. 6, pp. 2005-2011
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS
High incidence of human herpesvirus 6 infection with a high viral
load in cord blood stem cell transplant recipients
Junji Sashihara,
Keiko Tanaka-Taya,
Shinya Tanaka,
Kiyoko Amo,
Hiromi Miyagawa,
Gaku Hosoi,
Tomokuni Taniguchi,
Takafumi Fukui,
Naoki Kasuga,
Toshiya Aono,
Masahiro Sako,
Junichi Hara,
Koichi Yamanishi, and
Shintaro Okada
From the Department of Developmental Medicine
(Pediatrics) and Microbiology, Osaka University Graduate School of
Medicine, Suita, Japan; Osaka City General Hospital, Osaka, Japan;
Otsuka Assay Laboratory, Tokyo, Japan; Toyobo Research Center, Ohtsu,
Japan.
Human herpesvirus 6 (HHV-6) infection in recipients of cord blood
stem cell transplants (CBSCTs) was estimated by
semiquantitative and real-time quantitative polymerase chain reaction
(PCR) and reverse-transcription PCR. Of the CBSCT recipients, 7 (70%)
of 10 had active HHV-6 infection after transplantation, and all 7 were
inferred from their age to have already had a primary infection. Because HHV-6 DNA is seldom detected in cord blood, these cases were
considered likely to represent reactivation. In contrast, the 3 patients without HHV-6 infection were all believed to be naive
regarding HHV-6 primary infection because of their age and the results
of PCR assays given before the transplantation procedure. The incidence
of HHV-6 infection after transplantation was significantly higher
(P < .05) than after bone marrow (BM) transplantation
and peripheral blood stem cell (PBSC) transplantation, when recipients without primary HHV-6 infection prior to transplantation were excluded
(CBSCT, 100%; BMT/PBSCT, 56.3%). Real-time PCR revealed a higher
level of viral DNA in the peripheral blood mononuclear cells from CBSCT
recipients than from BMT/PBSCT recipients or patients with exanthem
subitum (P < .05). HHV-6 mRNA of the U79/80 gene was also detected by reverse-transcription PCR in all
analyzed patients with HHV-6 infection. Its detection was correlated
with the emergence of viral DNA in the plasma and symptoms such as fever and rash. Thus, HHV-6 infection was more frequent and the viral
load was higher in CBSCT recipients with prior primary infection.
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