HHV-6 in HCT recipients

M. Boeckh, D. Zerr

 

Studies are ongoing to define the impact of HHV-6 in HCT recipients in collaboration with Danielle Zerr, MD Children's Hospital . Epidemiologic studies are aimed to define the role of HHV-6 in central nervous system abnormalities after HCT.   A large prospective observational study with frequent measurements of HHV-6 and testing of delirium is ongoing.   Laboratory studies are aimed at examining the mechanisms of HHV-6-associated marrow suppression.  

Specific aims are:

1. To evaluate the association between HHV-6 reactivation and CNS dysfunction and to define the spectrum and incidence of CNS dysfunction preceded by HHV-6 reactivation.

Hypothesis.   HCT recipients with HHV-6 plasma reactivation during the initial three months following transplant will develop more frequent and more severe cognitive abnormalities as defined by standardized neuropsychiatric instruments (Delirium Rating Scale and the Memorial Delirium Assessment Scale) than HCT recipients without HHV-6 reactivation.

      2.  To define the short- and long-term outcomes of HHV-6 associated CNS dysfunction following HCT.

Hypothesis .   Patients with HHV-6 CNS dysfunction, as defined by persistent delirium in the setting of HHV-6 reactivation, are more likely to suffer persistent cognitive abnormalities than patients without HHV-6 CNS dysfunction following HCT.

HHV-6 References

Zerr DM, Meier AS, Selke SS, Frenkel LM, Huang ML, Wald A, Rhoads MP, Nguy L, Bornemann R, Morrow RA, Corey L.. A population-based study of primary human herpesvirus 6 infection. N Engl J Med. 2005 Feb 24;352(8):768-76.

Zerr DM, Gupta D, Huang ML, Carter R, Corey L. Effect of antivirals on human herpesvirus 6 replication in hematopoietic stem cell transplant recipients.Clin Infect Dis. 2002 Feb 1;34(3):309-17.

Zerr DM, Gooley TA, Yeung L, Huang ML, Carpenter P, Wade JC, Corey L, Anasetti C.Human herpesvirus 6 reactivation and encephalitis in allogeneic bone marrow transplant recipients. Clin Infect Dis. 2001 Sep 15;33(6):763-71.

Zerr, D.M., Corey, L., Kim, H.W., Huang, M.L., Nguy, L., Boeckh, M. Clinical outcomes of HHV-6 reactivation after hematopoietic stem cell transplantation.   Clin Inf Dis 40 :932-940, 2005 .