Severe hepatitis with autoimmune features following a HHV-6: a case report

Grima, Pierfrancesco; Chiavaroli, Roberto; Calabrese, Paola; Tundo, Paolo; Grima, Piero

doi:10.1186/1757-1626-1-110

Cited by 29 publications

(28 citation statements)

References 16 publications

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“…A role for HHV-6A and HHV-6B has been proposed in several autoimmune disorders, including autoimmune hemolytic anemia/neutropenia [89], autoimmune acute hepatitis [90], MS [91], scleroderma [92] and Hashimoto's thyroiditis [93], among others. Early observations documented a higher rate of viral isolation in patients with collagen vascular diseases compared with healthy subjects [94].…”

Section: Mechanisms Of Immunomodulation and Immunosuppression By Hhv-6amentioning

confidence: 99%

Immunomodulation and Immunosuppression by Human Herpesvirus 6A and 6B

2013

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Like other members of the Herpesviridae family, human herpesvirus (HHV)-6A and HHV-6B have developed a wide variety of strategies to modulate or suppress host immune responses and, thereby, facilitate their own spread and persistence in vivo. Long considered two variants of the same virus, HHV-6A and HHV-6B have recently been reclassified as distinct viral species, although the established nomenclature has been maintained. In this review, we summarize the distinctive profiles of interaction of these two viruses with the human immune system. Both HHV-6A and HHV-6B display a tropism for CD4+ T lymphocytes, but they can also infect, in a productive or nonproductive fashion, other cells of the immune system. However, there are important differences regarding the ability of each virus to infect cytotoxic effector cells, as HHV-6A has been shown to productively infect several of these cells, whereas HHV-6B infects them inefficiently at best. In addition to direct cytopathic effects, both HHV-6A and HHV-6B can interfere with immunologic functions to varying degrees via cytokine modulation, including blockade of IL-12 production by professional antigen-presenting cells, modulation of cell-surface molecules essential for T-cell activation, and expression of viral chemokines and chemokine receptors. Some of these effects are related to signaling through and downregulation of the viral receptor, CD46, a key molecule linking innate and adaptive immune responses. Increasing attention has recently been focused on the importance of viral interactions with dendritic cells, which may serve both as targets of virus-mediated immunosuppression and as vehicles for viral transfer to CD4+ T cells. Our deepening knowledge of the mechanisms developed by HHV-6A and HHV-6B to evade immunologic control may lead to new strategies for the prevention and treatment of the diseases associated with these viruses. Moreover, elucidation of these viral mechanisms may uncover new avenues to therapeutically manipulate or modulate the immune system in immunologically mediated human diseases.

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Section: Mechanisms Of Immunomodulation and Immunosuppression By Hhv-6amentioning

confidence: 99%

Immunomodulation and Immunosuppression by Human Herpesvirus 6A and 6B

2013

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“…В послед-ние годы приводятся данные о поражении пече-ни, вызванные вирусами герпеса человека 6-го типа (ВГЧ-6), с возможностью развития хрони-ческого гепатита и формирования цирроза пече-ни [2,3,9,10].…”

Section: Introductionunclassified

Герпесвірусний Гепатит 6-Го Типу У Дитини Раннього Віку

Khodak¹,

Brailko²,

Mushenko³

2021

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Наведено клінічне спостереження дитини 1 року, у якої діагностовано гепатит у структурі реактивованої форми герпесвірусної інфекції 6-го типу. Відзначалося значне підвищення трансаміназ при нормальних інших біохімічних показниках печінки. Отримано ефект від призначення противірусної терапії ацикловіром внутрішньовенно.

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“…Even though the pathophysiology of this disease is not well known, it has previously been suggested that viral infections may trigger the development of AIH in susceptible individuals since viral epitopes can mimic autoantigen epitopes in the liver. Indeed, several cases of AIH have been reported in patients with persistently altered liver tests after acute hepatitis A, B, C or E infection, Epstein‐Barr virus and human herpes 6 virus …”

Section: Introductionmentioning

confidence: 99%

“…Indeed, several cases of AIH have been reported in patients with persistently altered liver tests after acute hepatitis A, B, C or E infection, Epstein-Barr virus and human herpes 6 virus. [2][3][4][5] Hepatitis E virus (HEV) is a small positive-strand RNA genome with eight genotypes. Genotypes 1 and 2 cause epidemic outbreaks in developing countries, they only infect humans, and its transmission is faecal-oral.…”

Section: Introductionmentioning

confidence: 99%

Higher seroprevalence of hepatitis E virus in autoimmune hepatitis: Role of false‐positive antibodies

Llovet

Gratacós‐Ginès

Ortiz

et al. 2020

Liver International

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Background and aims Recent studies have found an increase in the seroprevalence of hepatitis E virus (HEV) infection in patients with autoimmune hepatitis (AIH). We aimed to assess the prevalence of positive anti‐HEV IgM and IgG, and HEV‐RNA in a cohort of patients with AIH, to determine the impact of positive HEV serology on patient outcome, and to evaluate the role of hypergammaglobulinemia and positive autoantibodies in the presence of positive anti‐HEV serology. Methods One hundred and five patients tested for HEV infection between 2014 and 2018 were included in the study: 50 with chronic AIH (more than 1 year on treatment), and 55 with an acute hepatitis (30 patients with acute AIH and 25 with non‐AIH). Results Seroprevalence of HEV was higher in patients with acute AIH (17% vs 10% in patients with chronic AIH and 8% in patients with non‐AIH). Patients with acute AIH and positive anti‐HEV IgG were older (58 vs 40; P = .006), had higher IgG levels (27 g/dL vs 13 g/dL; P = .03) and antismooth muscle antibodies (ASMA) titres (1:160 vs 1:80; P = .045), and were more likely to have another autoimmune disease (60% vs 16%; P = .03). At the time of HEV testing, anti‐HEV IgG positive patients had significantly higher serum IgG levels (17 g/L vs 11 g/L; P = .009), ANA (1:160 vs 1:60; P = .026) and ASMA titres (1:80 vs 1:40; P = .021). Conclusion Seroprevalence of HEV in patients with AIH in Catalonia does not differ from that of the general population. The higher HEV seroprevalence in patients with acute AIH with higher levels of gammaglobulins and high antibody titres suggest the presence of cross‐reactivity between HEV and liver antigens.

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Severe hepatitis with autoimmune features following a HHV-6: a case report

Cited by 29 publications

References 16 publications

Immunomodulation and Immunosuppression by Human Herpesvirus 6A and 6B

Immunomodulation and Immunosuppression by Human Herpesvirus 6A and 6B

Герпесвірусний Гепатит 6-Го Типу У Дитини Раннього Віку

Higher seroprevalence of hepatitis E virus in autoimmune hepatitis: Role of false‐positive antibodies

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