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Late‐phase human herpesvirus 6B reactivation in hematopoietic stem cell transplant recipients
Author(s) -
Miura Hiroki,
Kawamura Yoshiki,
Hattori Fumihiko,
Tanaka Makito,
Kudo Kazuko,
Ihira Masaru,
Yatsuya Hiroshi,
Takahashi Yoshiyuki,
Kojima Seiji,
Yoshikawa Tetsushi
Publication year - 2018
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12916
Subject(s) - medicine , odds ratio , confidence interval , hematopoietic stem cell transplantation , transplantation , logistic regression , human herpesvirus 6 , risk factor , immunology , viral disease , virus , herpesviridae
Abstract Background We sought to determine whether late‐phase human herpesvirus 6B (HHV‐6B) infection in hematopoietic stem cell transplant (HSCT) recipients was associated with serious outcomes and mortality. Methods The occurrence and course of HHV‐6B infection was monitored for at least 60 days after transplant using virus isolation and real‐time polymerase chain reaction. Risk factors for late‐phase HHV‐6B infection were examined, and the propensity score was calculated with significant risk factors. The inverse probability‐weighted multivariable logistic regression analysis was performed to estimate odds ratios (ORs) and the 95% confidence intervals (95% CI) for mortality. Results Late‐phase HHV‐6B infection was observed in 12/89 (13.5%) of the HSCT recipients. Older age (OR: 10.3, 95% CI: 2.1/72.9, P = .0027), hematologic malignancy (OR: 10.3, 95% CI: 1.8/97.1, P = .0063), unrelated donor transplantation (OR: 5.3, 95% CI: 1.1/36.0, P = .0345), and sex‐mismatched donor transplantation (OR: 6.3, 95% CI: 1.4/39.5, P = .0149) were identified as risk factors for late‐phase HHV‐6B infection. Fifteen subjects died (17%). Inverse probability‐weighted multivariable logistic model analysis revealed that late‐phase HHV‐6B infection was an independent risk factor for mortality (OR: 4.2, 95% CI: 1.7/11.0, P = .0012). Among 5 of the fatal cases of late‐phase HHV‐6B infection, viral infection might be associated with severe clinical manifestations. Conclusion Late‐phase HHV‐6B infection in HSCT recipients was associated with worse outcomes. The full spectrum of clinical features of the infection has not been fully elucidated, and therefore, recipients with high‐risk factors for late‐phase HHV‐6B infection should be carefully monitored.