Human Herpesvirus 6 Encephalitis in Immunocompetent and Immunocompromised Hosts.

Adolescent Adult Antiviral Agents / cerebrospinal fluid Encephalitis, Viral / cerebrospinal fluid Female Hematopoietic Stem Cell Transplantation / methods Herpesvirus 6, Human / genetics Humans Immunocompromised Host / immunology Male Retrospective Studies Roseolovirus Infections / cerebrospinal fluid Seizures / immunology Young Adult

Journal

Neurology(R) neuroimmunology & neuroinflammation
ISSN: 2332-7812
Titre abrégé: Neurol Neuroimmunol Neuroinflamm
Pays: United States
ID NLM: 101636388

Informations de publication

Date de publication:
03 2021
Historique:
received: 13 06 2020
accepted: 02 11 2020
entrez: 15 2 2021
pubmed: 16 2 2021
medline: 29 10 2021
Statut: epublish

Résumé

The aim of this study was to analyze the clinical, radiologic, and biological features associated with human herpesvirus 6 (HHV-6) encephalitis in immunocompetent and immunocompromised hosts to establish which clinical settings should prompt HHV-6 testing. We performed a retrospective research in the virology database of Fondazione IRCCS Policlinico San Matteo (Pavia, Italy) for all patients who tested positive for HHV-6 DNA in the CSF and/or in blood from January 2008 to September 2018 and separately assessed the number of patients meeting the criteria for HHV-6 encephalitis in the group of immunocompetent and immunocompromised hosts. Of the 926 patients tested for HHV-6 during the period of interest, 45 met the study criteria. Among immunocompetent hosts (n = 17), HHV-6 encephalitis was diagnosed to 4 infants or children presenting with seizures or mild encephalopathy during primary HHV-6 infection (CSF/blood replication ratio <<1 in all cases). Among immunocompromised hosts (n = 28), HHV-6 encephalitis was diagnosed to 7 adolescents/adults with hematologic conditions presenting with altered mental status (7/7), seizures (3/7), vigilance impairment (3/7), behavioral changes (2/7), hyponatremia (2/7), and anterograde amnesia (1/7). Initial brain MRI was altered only in 2 patients, but 6 of the 7 had a CSF/blood replication ratio >1. The detection of a CSF/blood replication ratio >1 represented a specific feature of immunocompromised patients with HHV-6 encephalitis and could be of special help to establish a diagnosis of HHV-6 encephalitis in hematopoietic stem cell transplant recipients lacking radiologic evidence of limbic involvement.

Identifiants

DOI: 10.1212/NXI.0000000000000942 PMID: 33587722 PMC: PMC7963435
pubmed: 33587722
pii: 8/2/e942
doi: 10.1212/NXI.0000000000000942
pmc: PMC7963435
pii:
doi:

Substances chimiques

Antiviral Agents 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

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Auteurs

Giulia Berzero (G)

From the Neuroncology Unit (G.B., E.V., E.M.), and Neuroradiology Unit (M.P., A.P.), IRCCS Mondino Foundation, Pavia; Molecular Virology Unit (G.C., F.B.), Microbiology and Virology Department, Diagnostic Radiology, Interventional Radiology and Neuroradiology Unit (A.M.S.), Bone Marrow Transplantation Unit (A.A.C., P.B., O.B.), Infectious and Tropical Diseases Unit (A.D.M.), Pediatric Clinic (V.R., T.F., S.S.), and Pediatric Hematology/Oncology (F.C., M.Z.), Fondazione IRCCS Policlinico San Matteo, Pavia; and Department of Brain and Behavioral Sciences (A.P.), Department of Molecular Medicine (P.B., O.B.), and Department of Clinical, Surgical, Diagnostic and Paediatric Sciences (F.B.), University of Pavia, Italy.

Giulia Campanini (G)

From the Neuroncology Unit (G.B., E.V., E.M.), and Neuroradiology Unit (M.P., A.P.), IRCCS Mondino Foundation, Pavia; Molecular Virology Unit (G.C., F.B.), Microbiology and Virology Department, Diagnostic Radiology, Interventional Radiology and Neuroradiology Unit (A.M.S.), Bone Marrow Transplantation Unit (A.A.C., P.B., O.B.), Infectious and Tropical Diseases Unit (A.D.M.), Pediatric Clinic (V.R., T.F., S.S.), and Pediatric Hematology/Oncology (F.C., M.Z.), Fondazione IRCCS Policlinico San Matteo, Pavia; and Department of Brain and Behavioral Sciences (A.P.), Department of Molecular Medicine (P.B., O.B.), and Department of Clinical, Surgical, Diagnostic and Paediatric Sciences (F.B.), University of Pavia, Italy.

Elisa Vegezzi (E)

From the Neuroncology Unit (G.B., E.V., E.M.), and Neuroradiology Unit (M.P., A.P.), IRCCS Mondino Foundation, Pavia; Molecular Virology Unit (G.C., F.B.), Microbiology and Virology Department, Diagnostic Radiology, Interventional Radiology and Neuroradiology Unit (A.M.S.), Bone Marrow Transplantation Unit (A.A.C., P.B., O.B.), Infectious and Tropical Diseases Unit (A.D.M.), Pediatric Clinic (V.R., T.F., S.S.), and Pediatric Hematology/Oncology (F.C., M.Z.), Fondazione IRCCS Policlinico San Matteo, Pavia; and Department of Brain and Behavioral Sciences (A.P.), Department of Molecular Medicine (P.B., O.B.), and Department of Clinical, Surgical, Diagnostic and Paediatric Sciences (F.B.), University of Pavia, Italy.

Matteo Paoletti (M)

From the Neuroncology Unit (G.B., E.V., E.M.), and Neuroradiology Unit (M.P., A.P.), IRCCS Mondino Foundation, Pavia; Molecular Virology Unit (G.C., F.B.), Microbiology and Virology Department, Diagnostic Radiology, Interventional Radiology and Neuroradiology Unit (A.M.S.), Bone Marrow Transplantation Unit (A.A.C., P.B., O.B.), Infectious and Tropical Diseases Unit (A.D.M.), Pediatric Clinic (V.R., T.F., S.S.), and Pediatric Hematology/Oncology (F.C., M.Z.), Fondazione IRCCS Policlinico San Matteo, Pavia; and Department of Brain and Behavioral Sciences (A.P.), Department of Molecular Medicine (P.B., O.B.), and Department of Clinical, Surgical, Diagnostic and Paediatric Sciences (F.B.), University of Pavia, Italy.

Anna Pichiecchio (A)

From the Neuroncology Unit (G.B., E.V., E.M.), and Neuroradiology Unit (M.P., A.P.), IRCCS Mondino Foundation, Pavia; Molecular Virology Unit (G.C., F.B.), Microbiology and Virology Department, Diagnostic Radiology, Interventional Radiology and Neuroradiology Unit (A.M.S.), Bone Marrow Transplantation Unit (A.A.C., P.B., O.B.), Infectious and Tropical Diseases Unit (A.D.M.), Pediatric Clinic (V.R., T.F., S.S.), and Pediatric Hematology/Oncology (F.C., M.Z.), Fondazione IRCCS Policlinico San Matteo, Pavia; and Department of Brain and Behavioral Sciences (A.P.), Department of Molecular Medicine (P.B., O.B.), and Department of Clinical, Surgical, Diagnostic and Paediatric Sciences (F.B.), University of Pavia, Italy.

Anna Maria Simoncelli (AM)

From the Neuroncology Unit (G.B., E.V., E.M.), and Neuroradiology Unit (M.P., A.P.), IRCCS Mondino Foundation, Pavia; Molecular Virology Unit (G.C., F.B.), Microbiology and Virology Department, Diagnostic Radiology, Interventional Radiology and Neuroradiology Unit (A.M.S.), Bone Marrow Transplantation Unit (A.A.C., P.B., O.B.), Infectious and Tropical Diseases Unit (A.D.M.), Pediatric Clinic (V.R., T.F., S.S.), and Pediatric Hematology/Oncology (F.C., M.Z.), Fondazione IRCCS Policlinico San Matteo, Pavia; and Department of Brain and Behavioral Sciences (A.P.), Department of Molecular Medicine (P.B., O.B.), and Department of Clinical, Surgical, Diagnostic and Paediatric Sciences (F.B.), University of Pavia, Italy.

Anna Amelia Colombo (AA)

From the Neuroncology Unit (G.B., E.V., E.M.), and Neuroradiology Unit (M.P., A.P.), IRCCS Mondino Foundation, Pavia; Molecular Virology Unit (G.C., F.B.), Microbiology and Virology Department, Diagnostic Radiology, Interventional Radiology and Neuroradiology Unit (A.M.S.), Bone Marrow Transplantation Unit (A.A.C., P.B., O.B.), Infectious and Tropical Diseases Unit (A.D.M.), Pediatric Clinic (V.R., T.F., S.S.), and Pediatric Hematology/Oncology (F.C., M.Z.), Fondazione IRCCS Policlinico San Matteo, Pavia; and Department of Brain and Behavioral Sciences (A.P.), Department of Molecular Medicine (P.B., O.B.), and Department of Clinical, Surgical, Diagnostic and Paediatric Sciences (F.B.), University of Pavia, Italy.

Paolo Bernasconi (P)

From the Neuroncology Unit (G.B., E.V., E.M.), and Neuroradiology Unit (M.P., A.P.), IRCCS Mondino Foundation, Pavia; Molecular Virology Unit (G.C., F.B.), Microbiology and Virology Department, Diagnostic Radiology, Interventional Radiology and Neuroradiology Unit (A.M.S.), Bone Marrow Transplantation Unit (A.A.C., P.B., O.B.), Infectious and Tropical Diseases Unit (A.D.M.), Pediatric Clinic (V.R., T.F., S.S.), and Pediatric Hematology/Oncology (F.C., M.Z.), Fondazione IRCCS Policlinico San Matteo, Pavia; and Department of Brain and Behavioral Sciences (A.P.), Department of Molecular Medicine (P.B., O.B.), and Department of Clinical, Surgical, Diagnostic and Paediatric Sciences (F.B.), University of Pavia, Italy.

Oscar Borsani (O)

From the Neuroncology Unit (G.B., E.V., E.M.), and Neuroradiology Unit (M.P., A.P.), IRCCS Mondino Foundation, Pavia; Molecular Virology Unit (G.C., F.B.), Microbiology and Virology Department, Diagnostic Radiology, Interventional Radiology and Neuroradiology Unit (A.M.S.), Bone Marrow Transplantation Unit (A.A.C., P.B., O.B.), Infectious and Tropical Diseases Unit (A.D.M.), Pediatric Clinic (V.R., T.F., S.S.), and Pediatric Hematology/Oncology (F.C., M.Z.), Fondazione IRCCS Policlinico San Matteo, Pavia; and Department of Brain and Behavioral Sciences (A.P.), Department of Molecular Medicine (P.B., O.B.), and Department of Clinical, Surgical, Diagnostic and Paediatric Sciences (F.B.), University of Pavia, Italy.
ORCID: 0000-0001-7805-7806

Angela Di Matteo (A)

From the Neuroncology Unit (G.B., E.V., E.M.), and Neuroradiology Unit (M.P., A.P.), IRCCS Mondino Foundation, Pavia; Molecular Virology Unit (G.C., F.B.), Microbiology and Virology Department, Diagnostic Radiology, Interventional Radiology and Neuroradiology Unit (A.M.S.), Bone Marrow Transplantation Unit (A.A.C., P.B., O.B.), Infectious and Tropical Diseases Unit (A.D.M.), Pediatric Clinic (V.R., T.F., S.S.), and Pediatric Hematology/Oncology (F.C., M.Z.), Fondazione IRCCS Policlinico San Matteo, Pavia; and Department of Brain and Behavioral Sciences (A.P.), Department of Molecular Medicine (P.B., O.B.), and Department of Clinical, Surgical, Diagnostic and Paediatric Sciences (F.B.), University of Pavia, Italy.

Virginia Rossi (V)

From the Neuroncology Unit (G.B., E.V., E.M.), and Neuroradiology Unit (M.P., A.P.), IRCCS Mondino Foundation, Pavia; Molecular Virology Unit (G.C., F.B.), Microbiology and Virology Department, Diagnostic Radiology, Interventional Radiology and Neuroradiology Unit (A.M.S.), Bone Marrow Transplantation Unit (A.A.C., P.B., O.B.), Infectious and Tropical Diseases Unit (A.D.M.), Pediatric Clinic (V.R., T.F., S.S.), and Pediatric Hematology/Oncology (F.C., M.Z.), Fondazione IRCCS Policlinico San Matteo, Pavia; and Department of Brain and Behavioral Sciences (A.P.), Department of Molecular Medicine (P.B., O.B.), and Department of Clinical, Surgical, Diagnostic and Paediatric Sciences (F.B.), University of Pavia, Italy.
ORCID: 0000-0001-8363-9210

Thomas Foiadelli (T)

From the Neuroncology Unit (G.B., E.V., E.M.), and Neuroradiology Unit (M.P., A.P.), IRCCS Mondino Foundation, Pavia; Molecular Virology Unit (G.C., F.B.), Microbiology and Virology Department, Diagnostic Radiology, Interventional Radiology and Neuroradiology Unit (A.M.S.), Bone Marrow Transplantation Unit (A.A.C., P.B., O.B.), Infectious and Tropical Diseases Unit (A.D.M.), Pediatric Clinic (V.R., T.F., S.S.), and Pediatric Hematology/Oncology (F.C., M.Z.), Fondazione IRCCS Policlinico San Matteo, Pavia; and Department of Brain and Behavioral Sciences (A.P.), Department of Molecular Medicine (P.B., O.B.), and Department of Clinical, Surgical, Diagnostic and Paediatric Sciences (F.B.), University of Pavia, Italy.
ORCID: 0000-0003-0961-428X

Salvatore Savasta (S)

From the Neuroncology Unit (G.B., E.V., E.M.), and Neuroradiology Unit (M.P., A.P.), IRCCS Mondino Foundation, Pavia; Molecular Virology Unit (G.C., F.B.), Microbiology and Virology Department, Diagnostic Radiology, Interventional Radiology and Neuroradiology Unit (A.M.S.), Bone Marrow Transplantation Unit (A.A.C., P.B., O.B.), Infectious and Tropical Diseases Unit (A.D.M.), Pediatric Clinic (V.R., T.F., S.S.), and Pediatric Hematology/Oncology (F.C., M.Z.), Fondazione IRCCS Policlinico San Matteo, Pavia; and Department of Brain and Behavioral Sciences (A.P.), Department of Molecular Medicine (P.B., O.B.), and Department of Clinical, Surgical, Diagnostic and Paediatric Sciences (F.B.), University of Pavia, Italy.

Francesca Compagno (F)

From the Neuroncology Unit (G.B., E.V., E.M.), and Neuroradiology Unit (M.P., A.P.), IRCCS Mondino Foundation, Pavia; Molecular Virology Unit (G.C., F.B.), Microbiology and Virology Department, Diagnostic Radiology, Interventional Radiology and Neuroradiology Unit (A.M.S.), Bone Marrow Transplantation Unit (A.A.C., P.B., O.B.), Infectious and Tropical Diseases Unit (A.D.M.), Pediatric Clinic (V.R., T.F., S.S.), and Pediatric Hematology/Oncology (F.C., M.Z.), Fondazione IRCCS Policlinico San Matteo, Pavia; and Department of Brain and Behavioral Sciences (A.P.), Department of Molecular Medicine (P.B., O.B.), and Department of Clinical, Surgical, Diagnostic and Paediatric Sciences (F.B.), University of Pavia, Italy.

Marco Zecca (M)

From the Neuroncology Unit (G.B., E.V., E.M.), and Neuroradiology Unit (M.P., A.P.), IRCCS Mondino Foundation, Pavia; Molecular Virology Unit (G.C., F.B.), Microbiology and Virology Department, Diagnostic Radiology, Interventional Radiology and Neuroradiology Unit (A.M.S.), Bone Marrow Transplantation Unit (A.A.C., P.B., O.B.), Infectious and Tropical Diseases Unit (A.D.M.), Pediatric Clinic (V.R., T.F., S.S.), and Pediatric Hematology/Oncology (F.C., M.Z.), Fondazione IRCCS Policlinico San Matteo, Pavia; and Department of Brain and Behavioral Sciences (A.P.), Department of Molecular Medicine (P.B., O.B.), and Department of Clinical, Surgical, Diagnostic and Paediatric Sciences (F.B.), University of Pavia, Italy.

Fausto Baldanti (F)

From the Neuroncology Unit (G.B., E.V., E.M.), and Neuroradiology Unit (M.P., A.P.), IRCCS Mondino Foundation, Pavia; Molecular Virology Unit (G.C., F.B.), Microbiology and Virology Department, Diagnostic Radiology, Interventional Radiology and Neuroradiology Unit (A.M.S.), Bone Marrow Transplantation Unit (A.A.C., P.B., O.B.), Infectious and Tropical Diseases Unit (A.D.M.), Pediatric Clinic (V.R., T.F., S.S.), and Pediatric Hematology/Oncology (F.C., M.Z.), Fondazione IRCCS Policlinico San Matteo, Pavia; and Department of Brain and Behavioral Sciences (A.P.), Department of Molecular Medicine (P.B., O.B.), and Department of Clinical, Surgical, Diagnostic and Paediatric Sciences (F.B.), University of Pavia, Italy.

Enrico Marchioni (E)

From the Neuroncology Unit (G.B., E.V., E.M.), and Neuroradiology Unit (M.P., A.P.), IRCCS Mondino Foundation, Pavia; Molecular Virology Unit (G.C., F.B.), Microbiology and Virology Department, Diagnostic Radiology, Interventional Radiology and Neuroradiology Unit (A.M.S.), Bone Marrow Transplantation Unit (A.A.C., P.B., O.B.), Infectious and Tropical Diseases Unit (A.D.M.), Pediatric Clinic (V.R., T.F., S.S.), and Pediatric Hematology/Oncology (F.C., M.Z.), Fondazione IRCCS Policlinico San Matteo, Pavia; and Department of Brain and Behavioral Sciences (A.P.), Department of Molecular Medicine (P.B., O.B.), and Department of Clinical, Surgical, Diagnostic and Paediatric Sciences (F.B.), University of Pavia, Italy. enrico.marchioni@mondino.it.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adolescent › Human Herpesvirus 6 Encephalitis in...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Human Herpesvirus 6 Encephalitis in...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Anti-infectieux › Antiviraux › Human Herpesvirus 6 Encephalitis in...
questionsmedicales.fr › Maladies du système nerveux › Encéphalite › Encéphalite infectieuse › Encéphalite virale › Human Herpesvirus 6 Encephalitis in...
questionsmedicales.fr › Procédures de chirurgie opératoire › Transplantation › Transplantation cellulaire › Transplantation de cellules souches › Transplantation de cellules souches hématopoïétiques › Human Herpesvirus 6 Encephalitis in...
questionsmedicales.fr › Virus › Virus à ADN › Herpesviridae › Betaherpesvirinae › Roseolovirus › Herpèsvirus humain de type 6 › Human Herpesvirus 6 Encephalitis in...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Human Herpesvirus 6 Encephalitis in...
questionsmedicales.fr › Phénomènes du système immunitaire › Sujet immunodéprimé › Human Herpesvirus 6 Encephalitis in...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Human Herpesvirus 6 Encephalitis in...
questionsmedicales.fr › Infection › Maladies virales › Infections à virus à ADN › Infections à Herpesviridae › Infections à roséolovirus › Human Herpesvirus 6 Encephalitis in...
questionsmedicales.fr › États, signes et symptômes pathologiques › Signes et symptômes › Manifestations neurologiques › Crises épileptiques › Human Herpesvirus 6 Encephalitis in...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Jeune adulte › Human Herpesvirus 6 Encephalitis in...