A systematic review and meta-analysis of HHV-6 and mortality after hematopoietic cell transplant.

Autor: Stathis CJ; Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.; HHV-6 Foundation, Santa Barbara, CA, 93108, USA., Zhu H; HHV-6 Foundation, Santa Barbara, CA, 93108, USA.; Baylor College of Medicine, Houston, TX, USA., Carlin K; Seattle Children's Research Institute, Seattle, WA, USA., Phan TL; HHV-6 Foundation, Santa Barbara, CA, 93108, USA.; Division of Hematology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA., Toomey D; HHV-6 Foundation, Santa Barbara, CA, 93108, USA.; Geisinger Commonwealth School of Medicine, Scranton, PA, 18509, USA., Hill JA; Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA.; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, USA.; Department of Medicine, University of Washington, Seattle, WA, USA., Zerr DM; Seattle Children's Research Institute and Department of Pediatrics, University of Washington, Seattle, WA, USA. Danielle.zerr@seattlechildrens.org.
Jazyk: angličtina
Zdroj: Bone marrow transplantation [Bone Marrow Transplant] 2024 Dec; Vol. 59 (12), pp. 1683-1693. Date of Electronic Publication: 2024 Sep 08.
DOI: 10.1038/s41409-024-02398-w
Abstrakt: Human herpesvirus-6B (HHV-6B) reactivation has been associated with non-relapse mortality (NRM) and overall mortality (OM) following allogeneic hematopoietic stem cell transplant (HCT). We performed a systematic review and meta-analysis to better quantify the association. Studies were included if they systematically tested a cohort of HCT recipients for HHV-6 infection or reactivation and described mortality for patients with and without HHV-6B. Random effects models were used to assess the pooled effect of HHV-6B positivity on each outcome of interest. Bayesian aggregation was additionally performed if models included 10 or fewer studies. Eight studies were included in the NRM analysis, which demonstrated a significant association between HHV-6 detection and NRM (pooled effect: 1.84; 95% CI: 1.29-2.62) without significant heterogeneity (I 2  = 0.0%, p = 0.55). A Bayesian aggregation of the raw data used to construct the NRM random effects model supported these findings (95% credible interval: 0.15-1.13). Twenty-five studies were included in OM analysis, which showed a significant positive association (pooled effect: 1.37; 95% CI: 1.07-1.76), though considerable heterogeneity was observed (I 2  = 36.7%, p < 0.05). HHV-6 detection is associated with NRM and OM following HCT. Randomized trials are warranted to evaluate if preventing or treating HHV-6B reactivation improves outcomes.
Competing Interests: Competing interests: CS, HZ, KC, TP, and DT have no conflicts to disclose. JAH provides consulting for Allovir, Gilead, Karius, Symbio, and receives research support from Allovir, Gilead, Karius, and Merck. DMZ received research funding from Merck and served as a consultant for AlloVir by serving on clinical endpoint adjudication committees for two studies. Ethics approval and consent to participate: Our study is exempt from IRB approval as all data is publicly available.
(© 2024. The Author(s).)
Databáze: MEDLINE
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