Presence of human herpesvirus type 6, polyoma BK virus and parvovirus B19V in non-transplanted patients with hematological malignancies and neutropenic fever

Abstract

BackgroundFebrile neutropenia is a common complication in adult patients undergoing chemotherapy for hematological malignancies. A potential causative agent is identified in approximately one third of the fever episodes. ObjectivesWe here investigated whether reactivated infection with human herpes virus 6 (HHV-6), polyoma BK virus (BKV) and parvovirus B19 (B19V) is associated with this condition. Study DesignIn a cross-sectional study, blood samples were collected at hospitalization of adult patients who developed neutropenic fever during chemotherapy for non-transplanted hematological malignancies. Detection of HHV-6A, HHV-6B, BKV and B19V DNA was performed by quantitative PCR. Clinical and laboratory data were extracted from medical records. ResultsA total of 23 of 148 (16%) samples, representing 14 of 79 (18%) patients, were PCR positive for DNA representing at least one of the three viruses; HHV-6 (n = 7 samples), BKV (n = 16 samples) and B19V (n = 6 samples). None of the samples were positive for HHV-6A DNA and all B19V DNA positive samples had viral loads below 500 copies/mL. All fever episodes, with the exception of two episodes for one BKV DNA positive patient, presented alternative presumed causative agents of the fever as detected by routine clinical diagnostics. Levels of hemoglobin, leukocyte counts, neutrophil counts, electrolytes, and creatinine were comparable for fever episodes with and without detectable viral DNA. ConclusionAlthough HHV-6B, BKV and B19V DNA could be detected in blood during a few neutropenic febrile episodes in non-transplanted hematological patients, the presence was not clearly associated to the fever.