Fulminant hepatic failure attributed to infection with human herpesvirus 6 (HHV-6) in an immunocompetent woman: A case report and review of the literature

Charnot-Katsikas, Angella; Baewer, David; Cook, Linda; David, Michael Z.

doi:10.1016/j.jcv.2015.12.002

Cited by 18 publications

(12 citation statements)

References 49 publications

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“…Her hepatitis symptoms improved, but those of colitis did not, following intravenous ganciclovir and oral valganciclovir treatments (169). However, some cases of encephalitis associated with HHV6 or HHV7 (170)(171)(172)(173)(174), and fulminant hepatitis due to HHV6 (175)(176)(177)(178) have been reported in otherwise healthy individuals based on serology tests and/or the detection of viral DNA in CSF and/or whole blood. Patients who developed meningoencephalitis following HHV6 infection may also have ES manifestations (179,180).…”

Section: Immunity To Hhv6 and Hhv7mentioning

confidence: 99%

Human inborn errors of immunity to herpes viruses

Jouanguy

Béziat

Mogensen

et al. 2020

Current Opinion in Immunology

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Infections with any of the nine human herpes viruses (HHV) can be asymptomatic or lifethreatening. The study of patients with severe diseases caused by HHVs, in the absence of overt acquired immunodeficiency, has led to the discovery or diagnosis of various inborn errors of immunity. The related inborn errors of adaptive immunity disrupt α/β T-cell rather than B-cell immunity. Affected patients typically develop HHV infections in the context of other infectious diseases. However, this is not always the case, as illustrated by inborn errors of SAP-dependent Tcell immunity to EBV-infected B cells. The related inborn errors of innate immunity disrupt leukocytes other than T and B cells, non-hematopoietic cells, or both. Patients typically develop only a single type of infection due to HHV, although, again, this is not always the case, as illustrated by inborn errors of TLR3 immunity resulting in HSV-1 encephalitis in some patients and influenza pneumonitis in others. Most severe HHV infections in otherwise healthy patients remains unexplained. The forward human genetic dissection of isolated and syndromic HHV-

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Section: Immunity To Hhv6 and Hhv7mentioning

confidence: 99%

Human inborn errors of immunity to herpes viruses

Jouanguy

Béziat

Mogensen

et al. 2020

Current Opinion in Immunology

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“…In another study, ALF was associated with primary HHV-6 infection in one child (27). Several other HHV-6-associated cases have been reported, mainly in infants (8,12). Earlier cases of ALF have similarly been attributed to HHV-6, although the virus is not yet classified as a causative agent of liver disease (4).…”

Section: Discussionmentioning

confidence: 97%

“…Complications resulting from HHV-7 infection have also been identified as a risk in organ transplantation (10). On the other hand, although have been rarely described, there are increasing evidences of association between some betaherpesviruses and ALF in immunocompetent patients (11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

Multiplex qPCR Facilitates Identification of Betaherpesviruses in Patients With Acute Liver Failure of Unknown Etiology

Raposo

Alves

Silva

et al. 2019

Preprint

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Background: The etiology of acute liver failure (ALF) is often unknown and reported to be associated with herpesviruses in a number of cases. In this study, we examined for betaherpesviruses infections in patients with ALF of unknown etiology using a multiplex qPCR to Betaherpesviruses subfamily. Methods: Liver explant and serum samples from 27 patients with ALF of unknown etiology were analyzed with the aid of multiplex qPCR to identify betaherpesviruses. All positive samples were sequenced to confirm herpes infection and liver enzyme levels evaluated. Results: Betaherpesviruses infection was effectively detected using multiplex qPCR. Six (22%) HHV-6, one (3%) HCMV and two (7%) dual infections (one with HHV-7/HHV-6, and the other with HHV-7/ HCMV). Interestingly, HHV-7 was only detected in the presence of other betaherpesviruses. Sequencing information confirmed betaherpesviruses infection. High hepatic enzyme levels and INR values>1.5 were determined in all betaherpesvirus-positive patients. Conclusions: Multiplex qPCR facilitated efficient quantification, indicating that differentiation between betaherpesviruses is possible with the sole use of real-time PCR. Liver explant and serum samples were positive for some betaherpesviruses, and coinfection of HHV-7 with HHV-6 and HCMV was additionally detected. Based on these results, we propose that ALF patients should be screened for the presence of betaherpesviruses.

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“…In another study, ALF was associated with primary HHV-6 infection in one child [27]. Several other HHV-6-associated cases have been reported, mainly in infants [8, 12]. Earlier cases of ALF have similarly been attributed to HHV-6, although the virus is not yet classified as a causative agent of liver disease [4].…”

Section: Discussionmentioning

confidence: 99%

Multiplex qPCR facilitates identification of betaherpesviruses in patients with acute liver failure of unknown etiology

et al. 2019

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Background The etiology of acute liver failure (ALF) is often unknown and reported to be associated with herpesviruses in a number of cases. In this study, we examined for betaherpesviruses infections in patients with ALF of unknown etiology using a multiplex qPCR to Betaherpesviruses subfamily. Methods Liver explant and serum samples from 27 patients with ALF of unknown etiology were analyzed with the aid of multiplex qPCR to identify betaherpesviruses. All positive samples were sequenced to confirm herpes infection and liver enzyme levels evaluated. Results Betaherpesviruses infection was effectively detected using multiplex qPCR. Six (22%) HHV-6, one (3%) HCMV and two (7%) dual infections (one with HHV-7/HHV-6, and the other with HHV-7/ HCMV). Interestingly, HHV-7 was only detected in the presence of other betaherpesviruses. Sequencing information confirmed betaherpesviruses infection. High hepatic enzyme levels and INR values> 1.5 were determined in all betaherpesvirus-positive patients. Conclusions Multiplex qPCR facilitated efficient quantification, indicating that differentiation between betaherpesviruses is possible with the sole use of real-time PCR. Liver explant and serum samples were positive for some betaherpesviruses, and coinfection of HHV-7 with HHV-6 and HCMV was additionally detected. Based on these results, we propose that ALF patients should be screened for the presence of betaherpesviruses.

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Fulminant hepatic failure attributed to infection with human herpesvirus 6 (HHV-6) in an immunocompetent woman: A case report and review of the literature

Cited by 18 publications

References 49 publications

Human inborn errors of immunity to herpes viruses

Human inborn errors of immunity to herpes viruses

Multiplex qPCR Facilitates Identification of Betaherpesviruses in Patients With Acute Liver Failure of Unknown Etiology

Multiplex qPCR facilitates identification of betaherpesviruses in patients with acute liver failure of unknown etiology

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