Opportunistic Infections - Herpesviruses
Fred Hutchinson Cancer Research Center scientists are making strides in reducing the burden and potential danger of herpesvirus infections in patients with compromised immune systems, including those undergoing a bone marrow or stem cell transplantation.
- Herpesviruses belong to a large family of viruses that often are characterized by their ability to assume a latent state in the body. Latent virus can reactivate resulting in disease.
- The human herpesviruses include herpes simplex viruses 1 and 2 (that cause oral sores and genital infections), varicella-zoster virus (which causes chickenpox and shingles), Epstein-Barr virus (which causes infectious mononucleosis, also known as mono), HHV-6 which causes roseola in children, cytomegalovirus which causes birth defects and a mono-like illness in adults and HHV-8 which causes a cancer that is common in many areas of the world.
- There are no cures for herpesvirus infections, all of which are common in the United States. However, there are antiviral drugs that effectively suppress some of these viruses from reactivating.
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Prevention & Causes
Preventing CMV disease in cord blood recipients –Scientists at Fred Hutchinson Cancer Research Center developed a strategy for the prevention of cytomegalovirus (CMV) disease in patients receiving a cord blood transplant. The strategy, developed by Drs. Steve Pergam, Wendy Leisenring, Michael Boekch, Colleen Delaney and colleagues calls for ganciclovir (antiviral) to be administered before transplantation, high-dose acyclovir (antiviral) administered after transplantation, and then bi-weekly testing for the presence of the virus.
Reduced mortality from cytomegalovirus infections – A study examining mortality rates among hematopoietic cell transplant patients over a 10-year period found that the hazard of early cytomegalovirus disease (CMV) - a type of herpesvirus - decreased by 48 percent among all CMV patients. The study compared patients receiving transplants between the period of 2003-2007 as compared to 1993-1997. The reduction was attributed to improved detection methods and treatment for preventing CMV disease resulting from the reactivation of the virus.
The landmark study, published in 2010, was authored by a dozen Hutchinson Center researchers who applied their individual expertise to examining improved survival rates among transplant recipients. Learn more »
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Detection & Diagnosis
Optimized Detection of cytomegalovirus – Fred Hutchinson Cancer Research Center scientists developed a highly sensitive test for the detection of cytomegalovirus (CMV), a normally latent virus that can pose a serious risk to patients with compromised immune systems, such as those undergoing a bone marrow transplant. The new method, developed by Drs. Michael Boeckh, Larry Corey and colleagues, identifies DNA from the virus in plasma samples and is more sensitive than methods that rely on identifying antigens in the blood. The test also has other advantages, including working for large-scale testing of clinical samples and short lab-cycles.
Preventing shingles in transplant patients – Varicella zoster virus disease (commonly known as the shingles) can be prevented in patients receiving hematopoietic cells transplants from donors by taking acyclovir as a prophylaxis, particularly during the first year after transplantation. The study was conducted by Fred Hutch's Drs. Boekch and Mary Flowers.
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Treatment & Prognosis
Predicting clinical outcomes for HHV-6 reactivation – Researchers from Fred Hutchinson Cancer Research Center and Seattle Children’s determined for the first time that the reactivation of human herpesvirus 6 in hematopoietic stem cell transplant patients can lead to dangerous complications. Drs. Michael Boeckh and Larry Corey, and Danielle M. Zerr of Seattle Children’s, determined that viral reactivation is associated with subsequent delayed growth in the number of blood platelets and white blood cells after transplantation.
Herpesvirus and cognitive dysfunction – Reactivation of the HHV-6 herpes virus in hematopoietic cell transplant patients is linked to central nervous system dysfunction, according to a study by Drs. Danielle Zerr, Boeckh, Corey, Colleen Delaney, Jesse Fann, and Wendy Leisenring of Fred Hutchinson Cancer Research Center. The association allows future research to focus on determining whether prevention of HHV-6 reactivation will reduce cognitive dysfunction in transplant patients.
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