Effect of Antivirals on Human Herpesvirus 6 Replication in Hematopoietic Stem Cell Transplant Recipients

Clin Infect Dis. 2002 Feb 1;34(3):309-17. doi: 10.1086/338044. Epub 2001 Dec 26.

Abstract

Human herpesvirus 6 (HHV-6) appears to cause central nervous system (CNS) syndromes, especially in hematopoietic stem cell transplant (HSCT) recipients. We reviewed our experience with HHV-6-associated CNS disease to evaluate both the clinical and virological presentation and response to antiviral therapy. A search of our virology database from January 1998 through June 2000 identified 11 HSCT recipients who had HHV-6 DNA detected by polymerase chain reaction in cerebrospinal fluid (CSF); 8 of whom had CNS dysfunction without another clear etiology identified. HHV-6 levels in serum and CSF were evaluated before and after ganciclovir and/or foscarnet therapy. Median log HHV-6 CSF levels appeared to decrease over time concurrent with antiviral therapy (serum level, 2.0 vs. 0 copies/mL [P=.38]; CSF level, 4.4 vs. 2.0 copies/mL [P=.13], sign test). Our data suggests that HHV-6 may cause moderate to severe CNS disease after HSC transplantation. Prospective studies are needed to define the spectrum of HHV-6-associated disease and to determine whether antiviral therapy offers clinical benefit.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Antiviral Agents / pharmacology*
  • Child
  • DNA, Viral / cerebrospinal fluid
  • DNA, Viral / drug effects*
  • Encephalitis / complications
  • Encephalitis / virology
  • Female
  • Hematopoietic Stem Cell Transplantation
  • Herpesvirus 6, Human / classification
  • Herpesvirus 6, Human / drug effects*
  • Herpesvirus 6, Human / physiology
  • Humans
  • Male
  • Middle Aged
  • Roseolovirus Infections / complications
  • Virus Replication

Substances

  • Antiviral Agents
  • DNA, Viral