{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T13:59:54Z","timestamp":1785851994587,"version":"3.56.0"},"posted":{"date-parts":[[2026,8,2]]},"group-title":"Transplantation","reference-count":46,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T00:00:00Z","timestamp":1785628800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.medrxiv.org\/about\/FAQ#license"}],"funder":[{"name":"National Cancer Institute","award":["NCI-P30CA0087-48"],"award-info":[{"award-number":["NCI-P30CA0087-48"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,8,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:p>Viral infections remain a cause of substantial morbidity and mortality in allogeneic hematopoietic cell transplant (aHCT) recipients. While antiviral prophylaxis has dramatically reduced the risk of herpes simplex virus (HSV) disease, the relationship between HSV serostatus and major post-transplant complications in the context of HSV prophylaxis is unknown. We evaluated the association between HSV serostatus and survival among adults who received a first aHCT at the Fred Hutchinson Cancer Center between 2002 and 2022. Patients were screened for HSV-1 and HSV-2 by Western blot (WB) prior to transplant. We fit Cox proportional hazards models for mortality up to one year post-transplant, comparing HSV seropositive to seronegative patients. Models were adjusted for age, sex, cytomegalovirus (CMV) serostatus, conditioning regimen, disease risk, graft type and HLA matching, year of transplant and acute graft-versus host disease. A total of 4,016 aHCT recipients were included in this analysis. The cumulative all-cause 1-year mortality was 29.8%. For HSV-1, the adjusted hazard ratio (aHR) for all-cause mortality comparing seropositive to seronegative individuals was 1.20 (95% CI: 1.06-1.36). The aHRs for relapse, non-relapse mortality (NRM) and relapse-related mortality (RRM) were 1.46 (1.24-1.71), 1.04 (0.89-1.21), and 1.75 (1.40-2.19), respectively. For HSV-2, the aHRs for all-cause mortality, relapse, NRM, and RRM were 1.03 (0.93-1.14), 1.16 (1.03-1.31), 0.99 (0.87-1.13), and 1.13 (0.97-1.33), respectively. Despite universal antiviral prophylaxis, HSV-1 seropositivity was associated with higher mortality in the year after transplant, driven by RRM. Further studies are needed to confirm the association and understand the potential mechanisms underlying this relationship.<\/jats:p>\n                <jats:sec>\n                  <jats:title>Key Points<\/jats:title>\n                  <jats:list list-type=\"bullet\">\n                    <jats:list-item>\n                      <jats:p>Pre-transplant HSV-1 seropositivity was associated with higher 1-year mortality among adult aHCT recipients over a 20-year period<\/jats:p>\n                    <\/jats:list-item>\n                    <jats:list-item>\n                      <jats:p>HSV seropositivity was associated with relapse and relapse-related mortality; seropositivity was high in the study population<\/jats:p>\n                    <\/jats:list-item>\n                  <\/jats:list>\n                <\/jats:sec>","DOI":"10.64898\/2026.07.30.26359369","type":"posted-content","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T05:35:13Z","timestamp":1785735313000},"source":"Crossref","is-referenced-by-count":0,"title":["Herpes Simplex Virus Serostatus and 1-Year Mortality Among Allogeneic Hematopoietic Cell Transplant Recipients"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5147-5909","authenticated-orcid":false,"given":"Molly D.","family":"Fischer","sequence":"first","affiliation":[{"name":"Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Johnston","sequence":"additional","affiliation":[{"name":"Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA"},{"name":"Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA"},{"name":"Division of Allergy and Infectious 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J.","family":"McCulloch","sequence":"additional","affiliation":[{"name":"Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA"},{"name":"Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda M.","family":"Sandmaier","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine, University of Washington, Seattle, WA"},{"name":"Translational Science and Therapeutics Division, Fred Hutchinson Cancer Center, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7443-0527","authenticated-orcid":false,"given":"Alex L.","family":"Greninger","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Wald","sequence":"additional","affiliation":[{"name":"Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA"},{"name":"Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA"},{"name":"Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA"},{"name":"Department of Epidemiology, University of Washington, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven A.","family":"Pergam","sequence":"additional","affiliation":[{"name":"Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA"},{"name":"Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, 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