Cone R W, Huang M L, Corey L, Zeh J, Ashley R, Bowden R
Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA.
J Infect Dis. 1999 Feb;179(2):311-8. doi: 10.1086/314581.
Human herpesvirus 6 (HHV-6) DNA levels in peripheral blood mononuclear cells were prospectively evaluated in 20 cytomegalovirus-seronegative allogeneic marrow transplant patients and in 10 healthy control subjects. Blood and saliva specimens obtained weekly for 3 months after transplant were evaluated by quantitative HHV-6 polymerase chain reaction. One of 20 patients experienced primary HHV-6 infection after marrow transplant (seroconversion, HHV-6 viremia, skin rash); 18 of 20 had increased peripheral blood mononuclear cell HHV-6 DNA levels consistent with asymptomatic reactivations, and 1 patient experienced a reactivation-associated skin rash. Genotyping revealed HHV-6 variant B DNA in all cases. Therapy with acyclovir or intravenous immunoglobulin was not correlated with lower HHV-6 DNA levels. Thus, asymptomatic HHV-6 reactivations appear to be common following allogeneic marrow transplantation. Among HHV-6-seronegative and viral DNA-negative patients, primary HHV-6 infection can ensue in association with self-limited clinical symptoms, including diffuse maculopapular rash.
对20例巨细胞病毒血清学阴性的异基因骨髓移植患者和10例健康对照者的外周血单个核细胞中的人疱疹病毒6型（HHV-6）DNA水平进行了前瞻性评估。移植后3个月每周采集的血液和唾液标本通过定量HHV-6聚合酶链反应进行评估。20例患者中有1例在骨髓移植后发生原发性HHV-6感染（血清转化、HHV-6病毒血症、皮疹）；20例中有18例外周血单个核细胞HHV-6 DNA水平升高，符合无症状激活，1例患者出现与激活相关的皮疹。基因分型显示所有病例均为HHV-6 B型DNA。阿昔洛韦或静脉注射免疫球蛋白治疗与较低的HHV-6 DNA水平无关。因此，无症状HHV-6激活在异基因骨髓移植后似乎很常见。在HHV-6血清学阴性和病毒DNA阴性的患者中，原发性HHV-6感染可伴有自限性临床症状，包括弥漫性斑丘疹。
