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Human herpesvirus-6 infection in bone marrow transplantation
1Department of Pediatrics, Fujita Health University School of Medicine, Aichi, Japan.
Abstract:
Twenty-five pediatric patients who received bone marrow transplantation (BMT) were studied prospectively to determine the relationship between BMT and human herpesvirus-6 (HHV-6) infection by the virus isolation from peripheral blood and/or bone marrow and by determining neutralizing antibodies to HHV-6 during the 2 months following BMT. All of the 25 donors and the recipients were immune to HHV-6 at the time of BMT and the virus was not isolated from them. HHV-6 was isolated from peripheral blood and/or bone marrow mononuclear cells in ten (40%) of the 25 recipients between day 14 and day 22 of BMT, but not from any other day. Two additional recipients showed a significant increase in the antibody titer. Thus, infection with HHV-6 was confirmed in 12 (48%) of the 25 recipients. Four of the 12 developed skin rashes; three of these four had a febrile episode when the virus was isolated, whereas none of the remaining 13 developed the skin rash. These results suggest a frequent infection with HHV-6 only a few weeks after BMT and a close association between the infection with the virus and the development of skin rashes.
Insights
Pediatric bone marrow transplant (BMT) patients frequently experience human herpesvirus-6 (HHV-6) reactivation within weeks post-transplant. This HHV-6 infection is closely associated with the development of skin rashes in these vulnerable children.
Area of Science:
- Virology
- Pediatric Hematology
- Immunology
Background:
- Bone marrow transplantation (BMT) is a critical treatment for pediatric hematologic disorders.
- Human herpesvirus-6 (HHV-6) is a common virus that can cause complications in immunocompromised individuals.
- Understanding post-BMT viral infections is crucial for patient management.
Purpose of the Study:
- To investigate the incidence and timing of human herpesvirus-6 (HHV-6) infection following pediatric bone marrow transplantation (BMT).
- To determine the association between HHV-6 infection and clinical manifestations, specifically skin rashes, in BMT recipients.
Main Methods:
- Prospective study of 25 pediatric patients undergoing BMT.
- Monitoring for HHV-6 viral isolation in peripheral blood and/or bone marrow.
- Assessing neutralizing antibody titers to HHV-6 during the two months post-BMT.
- Clinical observation for development of skin rashes.
Main Results:
- HHV-6 was isolated from 40% (10/25) of recipients between days 14-22 post-BMT.
- Confirmed HHV-6 infection in 48% (12/25) of recipients, including those with increased antibody titers.
- Four patients developed skin rashes, three of whom had concurrent HHV-6 isolation and fever.
Conclusions:
- HHV-6 infection is frequent in pediatric BMT recipients, typically occurring a few weeks after transplantation.
- A significant association exists between HHV-6 infection and the development of skin rashes post-BMT.
- Early detection and monitoring of HHV-6 are important in the post-transplant period.