HHV-6 reactivation and its effect on delirium and cognitive functioning in hematopoietic cell transplantation recipients.

Abstract:

:Human herpesvirus 6 (HHV-6) is detected in the plasma of approximately 40% of patients undergoing hematopoietic cell transplantation (HCT) and sporadically causes encephalitis in this population. The effect of HHV-6 reactivation on central nervous system function has not been fully characterized. This prospective study aimed to evaluate associations between HHV-6 reactivation and central nervous system dysfunction after allogeneic HCT. Patients were enrolled before HCT. Plasma samples were tested for HHV-6 at baseline and twice weekly after transplantation until day 84. Delirium was assessed at baseline, 3 times weekly until day 56, and weekly on days 56 to 84 using a validated instrument. Neurocognitive testing was performed at baseline and at approximately day 84. HHV-6 was detected in 111 (35%) of the 315 included patients. Patients with HHV-6 were more likely to develop delirium (adjusted odds ratio = 2.5; 95% confidence interval, 1.2-5.3) and demonstrate neurocognitive decline (adjusted odds ratio = 2.6; 95% confidence interval, 1.1-6.2) in the first 84 days after HCT. Cord blood and unrelated transplantation increased risk of HHV-6 reactivation. These data provide the basis to conduct a randomized clinical trial to determine whether prevention of HHV-6 reactivation will reduce neurocognitive morbidity in HCT recipients.

journal_name

Blood

journal_title

Blood

authors

Zerr DM,Fann JR,Breiger D,Boeckh M,Adler AL,Xie H,Delaney C,Huang ML,Corey L,Leisenring WM

doi

10.1182/blood-2010-10-316083

subject

Has Abstract

pub_date

2011-05-12 00:00:00

pages

5243-9

issue

19

eissn

0006-4971

issn

1528-0020

pii

blood-2010-10-316083

journal_volume

117

pub_type

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