Wang F Z, Dahl H, Linde A, Brytting M, Ehrnst A, Ljungman P
Department of Medicine, Huddinge University Hospital, Sweden.
Blood. 1996 Nov 1;88(9):3615-20.
Human herpesvirus-6 (HHV-6), human herpesvirus-7 (HHV-7), Epstein-Barr virus (EBV), and human cytomegalovirus (CMV) DNA were repeatedly assayed in peripheral blood leukocytes from 37 allogeneic bone marrow transplant (BMT) patients by polymerase chain reaction. Before BMT, HHV-6 DNA was detected in 8 (22%) patients. HHV-7, EBV, and CMV DNA were detected in 21 (57%), 10 (27%), and 1 (3%) patient, respectively. After BMT, HHV-6 DNA was detected in 26 (70%), HHV-7 in 21 (57%), EBV in 28 (76%), and CMV in 21 (57%) patients. Thirty-two (87%) patients were positive with more than one virus. HHV-6, HHV-7, and EBV DNA were found earlier than CMV DNA in most patients after BMT. The proportions of HHV-6-positive samples during the first 3 months after BMT were higher in the patients with either delayed granulocyte engraftment (P = .04, Fisher's exact test) or delayed platelet engraftment (P = .001, Fisher's exact test). The HHV-6 DNA in samples from the patients with delayed engraftment was confirmed to be variant B. The detection of any lymphotropic herpesvirus was not related to the development of acute graft-versus-host disease (aGVHD). High-dose acyclovir (ACV) prophylaxis significantly (P < .01) reduced the proportion of HHV-6-positive samples and tended to lower HHV-6 DNA levels (P = .06). Our data indicate that HHV-6 variant B can inhibit marrow engraftment and that high-dose ACV may be beneficial to engraftment after BMT by preventing HHV-6 reactivation. No relation between the proportions of HHV-7-, EBV-, and CMV-positive samples in the first 3 months and engraftment or aGVHD was found.
通过聚合酶链反应对37例异基因骨髓移植（BMT）患者外周血白细胞中的人疱疹病毒6型（HHV-6）、人疱疹病毒7型（HHV-7）、爱泼斯坦-巴尔病毒（EBV）和人巨细胞病毒（CMV）DNA进行了多次检测。在BMT前，8例（22%）患者检测到HHV-6 DNA。HHV-7、EBV和CMV DNA分别在21例（57%）、10例（27%）和1例（3%）患者中检测到。BMT后，26例（70%）患者检测到HHV-6 DNA，21例（57%）检测到HHV-7，28例（76%）检测到EBV，21例（57%）检测到CMV。32例（87%）患者感染了不止一种病毒。在大多数BMT后的患者中，HHV-6、HHV-7和EBV DNA比CMV DNA更早被发现。在粒细胞植入延迟（P = 0.04，Fisher精确检验）或血小板植入延迟（P = 0.001，Fisher精确检验）的患者中，BMT后前3个月HHV-6阳性样本的比例更高。植入延迟患者样本中的HHV-6 DNA被确认为B型变异株。任何嗜淋巴细胞疱疹病毒的检测与急性移植物抗宿主病（aGVHD）的发生均无关。高剂量阿昔洛韦（ACV）预防显著（P < 0.01）降低了HHV-6阳性样本的比例，并倾向于降低HHV-6 DNA水平（P = 0.06）。我们的数据表明，HHV-6 B型变异株可抑制骨髓植入，高剂量ACV通过预防HHV-6再激活可能对BMT后的植入有益。未发现前3个月HHV-7、EBV和CMV阳性样本比例与植入或aGVHD之间的关系。
