Viral load and ganciclovir (GCV) concentration in cerebrospinal fluid of patients successfully treated with GCV or valGCV for human herpesvirus 6 encephalitis/myelitis following umbilical cord blood transplantation

Transpl Infect Dis. 2016 Oct;18(5):773-776. doi: 10.1111/tid.12579. Epub 2016 Sep 7.

Abstract

We describe successful treatment of 3 cases of human herpesvirus 6 (HHV-6) encephalitis/myelitis following cord blood transplantation (CBT). Ganciclovir (GCV) (10 mg/kg/day) reduced HHV-6 load to undetectable levels in cerebrospinal fluid (CSF). Early dose reduction in the presence of HHV-6 detectable in CSF resulted in an increased HHV-6 load. GCV was capably shifted to valganciclovir (VGCV) with an almost equivalent concentration. GCV/VGCV may be effective for HHV-6 encephalitis/myelitis after CBT, although HHV-6 load in CSF should be monitored.

Keywords: HHV-6; cerebrospinal fluid; cord blood transplantation; encephalitis; ganciclovir; valganciclovir.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antiviral Agents / administration & dosage
  • Antiviral Agents / therapeutic use*
  • Child, Preschool
  • DNA, Viral
  • Encephalitis, Viral / cerebrospinal fluid
  • Encephalitis, Viral / drug therapy*
  • Encephalitis, Viral / virology
  • Female
  • Fetal Blood
  • Ganciclovir / administration & dosage
  • Ganciclovir / analogs & derivatives
  • Ganciclovir / therapeutic use
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Herpesvirus 6, Human / isolation & purification*
  • Humans
  • Male
  • Myelitis / cerebrospinal fluid
  • Myelitis / drug therapy*
  • Myelitis / virology
  • Myeloablative Agonists / adverse effects
  • Roseolovirus Infections / cerebrospinal fluid
  • Roseolovirus Infections / drug therapy*
  • Roseolovirus Infections / virology
  • Transplantation Conditioning / adverse effects*
  • Treatment Outcome
  • Valganciclovir
  • Viral Load / drug effects*
  • Young Adult

Substances

  • Antiviral Agents
  • DNA, Viral
  • Myeloablative Agonists
  • Valganciclovir
  • Ganciclovir

Supplementary concepts

  • Human Herpesvirus 6 encephalitis