Encephalitis caused by human herpesvirus-6 in transplant recipients - relevance of a novel neurotropic virus

Singh, Nina and Paterson, David L. (2000) Encephalitis caused by human herpesvirus-6 in transplant recipients - relevance of a novel neurotropic virus. Transplantation, 69 12: 2474-2479. doi:10.1097/00007890-200006270-00002


Author Singh, Nina
Paterson, David L.
Title Encephalitis caused by human herpesvirus-6 in transplant recipients - relevance of a novel neurotropic virus
Journal name Transplantation   Check publisher's open access policy
ISSN 0041-1337
Publication date 2000-06-27
Sub-type Article (original research)
DOI 10.1097/00007890-200006270-00002
Volume 69
Issue 12
Start page 2474
End page 2479
Total pages 6
Place of publication Baltimore Md., U.S.A.
Publisher Lippincott Williams & Wilkins
Language eng
Subject 1103 Clinical Sciences
1117 Public Health and Health Services
Formatted abstract
Background.
Human herpesvirus-6 (HHV-6) is a neurotropic virus. Encephalitis is a significant clinical manifestation of HHV-6; however, sparse data on this entity exist in transplant recipients.

Methods.

Cases of HHV-6 encephalitis reported in the literature (13 bone marrow transplant recipients and 1 liver transplant recipient) were reviewed. The diagnosis was established in all by viral isolation and/or detection of HHV-6 DNA in the cerebrospinal fluid by polymerase chain reaction or histopathologic method.

Results.

HHV-6 encephalitis occurred a median of 45 days (range 10 days to 15 months) after transplantation. Mental status changes, ranging from confusion to coma (92%), seizures (25%), and headache (25%) were the predominant clinical presentations. Focal neurologic findings occurred in only 17% of the patients. Twenty-five percent of the patients had fever; however, the height of fever (≤40°C) in febrile patients was striking. Cerebrospinal fluid pleocytosis was generally lacking. Abnormal neuroimaging findings, characterized by low-attenuation lesions in the posterior cerebral lobes, were present only in 17% of the patients. Overall mortality in patients with HHV-6 encephalitis was 58% (7 of 12); 42% (5 of 12) of the deaths were caused by HHV-6. Cure was documented in 7 of 8 patients who received ganciclovir or foscarnet for ≥7 days, compared with 0% (0 of 4) in those who did not receive these drugs or received them for < 7 days (P=.01).

Conclusions.
HHV-6 may be associated with encephalitis after transplantation and warrants consideration in transplant recipients with encephalitis of unidentifiable etiology.
Keyword Bone-marrow-transplantation
Neurologic Complications
Liver-transplantation
Fatal Encephalitis
Infection
Human-herpesvirus-6
Encephalopathy
Identification
Ganciclovir
Pathogen
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collection: UQ Centre for Clinical Research Publications
 
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Created: Tue, 07 Sep 2010, 17:12:10 EST