Severe encephalitis in a haematopoietic stem cell transplant recipient caused by reactivation of human herpesvirus 6 and 7

Holden, Stephen R.; Vas, A

doi:10.1016/j.jcv.2007.08.011

Cited by 19 publications

(18 citation statements)

References 7 publications

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“…Beta herpes viruses (CMV, HHV-6 and HHV-7) can establish latent infections in peripheral mononuclear cells (PBMCs) [16], [17] and can be reactivated in immuno-suppressed individuals and lead to clinical symptoms [27], [33]. P. falciparum infected erythrocytes have been reported to directly interact with a variety of PBMCs such as monocytes/macrophages, platelets, granulocytes [34], dendritic cells [35] and B cells [36].…”

Section: Discussionmentioning

confidence: 99%

Effect of Acute Plasmodium falciparum Malaria on Reactivation and Shedding of the Eight Human Herpes Viruses

et al. 2011

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Human herpes viruses (HHVs) are widely distributed pathogens. In immuno-competent individuals their clinical outcomes are generally benign but in immuno-compromised hosts, primary infection or extensive viral reactivation can lead to critical diseases. Plasmodium falciparum malaria profoundly affects the host immune system. In this retrospective study, we evaluated the direct effect of acute P. falciparum infection on reactivation and shedding of all known human herpes viruses (HSV-1, HSV-2, VZV, EBV, CMV, HHV-6, HHV-7, HHV-8). We monitored their presence by real time PCR in plasma and saliva of Ugandan children with malaria at the day of admission to the hospital (day-0) and 14 days later (after treatment), or in children with mild infections unrelated to malaria. For each child screened in this study, at least one type of HHV was detected in the saliva. HHV-7 and HHV-6 were detected in more than 70% of the samples and CMV in approximately half. HSV-1, HSV-2, VZV and HHV-8 were detected at lower frequency. During salivary shedding the highest mean viral load was observed for HSV-1 followed by EBV, HHV-7, HHV-6, CMV and HHV-8. After anti-malarial treatment the salivary HSV-1 levels were profoundly diminished or totally cleared. Similarly, four children with malaria had high levels of circulating EBV at day-0, levels that were cleared after anti-malarial treatment confirming the association between P. falciparum infection and EBV reactivation. This study shows that acute P. falciparum infection can contribute to EBV reactivation in the blood and HSV-1 reactivation in the oral cavity. Taken together our results call for further studies investigating the potential clinical implications of HHVs reactivation in children suffering from malaria.

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Section: Discussionmentioning

confidence: 99%

Effect of Acute Plasmodium falciparum Malaria on Reactivation and Shedding of the Eight Human Herpes Viruses

et al. 2011

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“…HHV-6 is known to induce meningoencephalitis in immunocompromised hosts, especially in solid organ or blood marrow transplant recipients. [3][4][5] Such an occurrence in immunocompetent patients is very rare and none of 253 cases were retained in the recent French national prospective study on meningoencephalitis. 13 A recent review of the literature reported only 14 cases of this kind of manifestation.…”

Section: Discussionmentioning

confidence: 99%

“…The virus is believed to be implicated in central nervous system diseases with seizures in immunocompetent patients 2 and encephalitis in immunocompromised adults. 3,4 It has also been involved in pneumonitis in solid organs 5 and bone marrow transplant recipients 1 and in delayed engraftment in stem cell transplant recipients. 6 However, the role of HHV-6 in human disease remains to be fully specified.…”

Section: Introductionmentioning

confidence: 99%

Detection of HHV-6 in over a thousand samples: New types of infection revealed by an analysis of positive results

Revest

Minjolle

Veyer

et al. 2011

Journal of Clinical Virology

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“…But the association of HHV-6 encephalitis and GBS in the HSCT setting has very limited observations [10]. Post-transplant GBS has usually been attributed to infection and very rarely to neurotoxicity of conditioning regimens [4, 10]. Approximately 75% of patients show signs of infection shortly preceding diagnosis of GBS [4, 10].…”

Section: Discussionmentioning

confidence: 99%

“…Post-transplant GBS has usually been attributed to infection and very rarely to neurotoxicity of conditioning regimens [4, 10]. Approximately 75% of patients show signs of infection shortly preceding diagnosis of GBS [4, 10]. The detection of HHV-6 DNA in CSF is a strong indication that the virus is actively replicating within the CNS.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous human herpesvirus 6-associated encephalitis and Guillain-Barré syndrome in a patient after matched unrelated donor haematopoietic stem cell transplantation

Tomaszewska¹,

Nasiłowska-Adamska²,

Dzieciątkowski³

et al. 2010

aoms

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A b s t r a c tViral infections are still a serious diagnostic and therapeutic problem in patients undergoing alternative donor transplants. β-Herpesviruses (especially human herpesvirus type 5, 6 and 7) are recognized pathogens in this group of patients and may cause central nervous system disease. Guillain-Barré syndrome (GBS) is a very rare complication among stem cell transplant recipients and usually has been attributed to infection. We report a case of resolving simultaneous GBS and HHV-6-associated encephalitis in a haematopoietic stem cell transplant recipient with preceding reactivation of cytomegalovirus (CMV) infection. According to our knowledge this well-documented case is probably the first report from Poland.

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Severe encephalitis in a haematopoietic stem cell transplant recipient caused by reactivation of human herpesvirus 6 and 7

Cited by 19 publications

References 7 publications

Effect of Acute Plasmodium falciparum Malaria on Reactivation and Shedding of the Eight Human Herpes Viruses

Effect of Acute Plasmodium falciparum Malaria on Reactivation and Shedding of the Eight Human Herpes Viruses

Detection of HHV-6 in over a thousand samples: New types of infection revealed by an analysis of positive results

Simultaneous human herpesvirus 6-associated encephalitis and Guillain-Barré syndrome in a patient after matched unrelated donor haematopoietic stem cell transplantation

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