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Infections

Human herpesvirus 6B reactivation and delirium are frequent and associated events after cord blood transplantation

Bone Marrow Transplantation volume 50, pages 1348–1351 (2015)Cite this article

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Abstract

Human herpesvirus 6B (HHV-6B) frequently reactivates after cord blood transplantation (CBT). We previously reported an association between HHV-6B reactivation and delirium after hematopoietic cell transplantation. In this prospective study, 35 CBT recipients underwent twice-weekly plasma PCR testing for HHV-6 and thrice-weekly delirium assessment until day 84. There was a quantitative association between HHV-6B reactivation and delirium in univariable (odds ratio, 2.88; 95% confidence interval (CI), 0.97–8.59) and bivariable models. In addition, intensified prophylaxis with high-dose valacyclovir mitigated HHV-6B reactivation (adjusted hazard ratio, 0.39; 95% CI, 0.14–1.08). Larger trials are needed to explore the utility of HHV-6B prophylaxis after CBT.

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Acknowledgements

We thank the patients and their families who participated in this study, without whose patience and dedication this study could not have been undertaken. This work was supported by the National Institutes of Health (grant numbers R01 AI057639-05S1, DMZ; CA018029 and K24 HL093294, MB). The funding source had no involvement in the study design, collection, analysis and interpretation of data. Ethical approval: all patients provided written consent, and the protocol was approved by the Fred Hutchinson Cancer Research Center Institutional Review Board.

Author contributions

DMZ, MB, JAH, ALA, M-LH, JRF, CD and WML participated in the study design, data analysis and interpretation, and critical review of the report; JH wrote the first draft and all revisions of the report; and HX and WML performed the statistical analyses and participated in revision of the report.

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Authors and Affiliations

  1. Department of Medicine, University of Washington, Seattle, WA, USA

    J A Hill & M Boeckh

  2. Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    J A Hill, M Boeckh, M-L Huang, J R Fann, C Delaney & D M Zerr

  3. Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    W M Leisenring & H Xie

  4. Pediatric Infectious Diseases, Seattle Children’s Research Institute, Seattle, WA, USA

    A L Adler & D M Zerr

  5. Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA

    J R Fann

  6. Department of Pediatrics, University of Washington, Seattle, WA, USA

    C Delaney & D M Zerr

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  1. J A Hill
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  9. D M Zerr
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Corresponding author

Correspondence to D M Zerr.

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Competing interests

MB received research funding for clinical trials and consulting fees from Chimerix Inc., Genentech/Roche and Gilead in addition to consulting for Clinigen. DMZ received research funding from Chimerix Inc. All other authors report no potential conflicts.

Additional information

Presented in poster form at IDWeek 2014, Philadelphia, PA. 2014: Abstract 45379.

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Hill, J., Boeckh, M., Leisenring, W. et al. Human herpesvirus 6B reactivation and delirium are frequent and associated events after cord blood transplantation. Bone Marrow Transplant 50, 1348–1351 (2015). https://doi.org/10.1038/bmt.2015.154

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