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Herpesvirus type 6 in patients undergoing bone marrow transplantation:
serologic features and detection by polymerase chain reaction
F Wilborn, V Brinkmann, CA Schmidt, F Neipel, H Gelderblom and W Siegert
Abteilung Innere Medizin, Klinikum Rudolf Virchow, Freie Universitat
Berlin, Germany.
To evaluate the potential role of human herpesvirus type 6 (HHV-6)
infection in patients after bone marrow transplantation (BMT) we
sequentially analyzed buffy coat leukocytes, oral lavage fluid, and urine
from 57 patients for the presence of HHV-6 DNA by polymerase chain reaction
(PCR) before and after 60 BMTs. Twenty-four patients undergoing autologous
BMT and 36 with allogeneic BMT were studied. Thirty-six patients (60%) were
PCR positive in one or more tests. The majority of PCR-positive patients
had positive results only sporadically, in 1 (n = 23) or 2 weeks (n = 5).
Six patients were positive in 3 to 5 weeks. In 2 patients, we found a high
frequency of positive tests, in 7 of 7 and 10 of 10 weeks analyzed.
Twenty-four patients (40%) remained PCR negative throughout the post-BMT
period. There was a significant correlation between the results of HHV-6
PCR and the occurrence of acute graft-versus-host disease (aGVHD). In grade
II-IV, 6 of 8 (75%) patients had 2 or more positive PCR tests, compared
with 5 of 25 (20%) patients without or with grade I aGVHD (P = .01). There
was no difference in the outcome of PCR tests with respect to the type of
BMT or pre-BMT HHV-6 enzyme-linked immunosorbent assay titers. Restriction
enzyme analysis of PCR amplificates from 18 patients showed HHV-6 variant B
in 16 (88.9%) and variant A in 2 cases (11.1%). We conclude that HHV-6 DNA
can be detected in 60% of the patients after BMT. HHV-6 DNA can be detected
more frequently in patients with moderate and severe aGVHD than in patients
without aGVHD or with mild aGVHD.
Volume 83,
Issue 10,
pp. 3052-3058,
05/15/1994
Copyright © 1994 by The American Society of Hematology
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