Herpes Simplex Virus Serostatus and 1-Year Mortality Among Allogeneic Hematopoietic Cell Transplant Recipients

The study examined the relationship between Herpes Simplex Virus (HSV) serostatus and survival in 4,016 patients who underwent allogeneic hematopoietic cell transplantation between 2002 and 2022. The overall 1-year all-cause mortality was 29.8 percent. Patients with HSV-1 seropositive status had a higher adjusted mortality hazard ratio (1.20) compared to seronegative patients. For HSV-1, increased rates of relapse (1.46) and relapse-related mortality (1.75) were observed. HSV-2 serostatus was not significantly associated with overall mortality. Despite universal antiviral prophylaxis, HSV-1 seropositivity was associated with higher mortality in the year after transplantation, driven primarily by relapse-related mortality.