Emerging shadows: HHV-8-associated encephalitis unveiled in a solid organ transplant recipient.


Journal

Transplant infectious disease : an official journal of the Transplantation Society
ISSN: 1399-3062
Titre abrégé: Transpl Infect Dis
Pays: Denmark
ID NLM: 100883688

Informations de publication

Date de publication:
16 Jul 2024
Historique:
revised: 30 06 2024
received: 25 06 2024
accepted: 02 07 2024
medline: 16 7 2024
pubmed: 16 7 2024
entrez: 16 7 2024
Statut: aheadofprint

Résumé

Human herpesviruses (HHVs) cause a wide variety of central nervous system (CNS) infections including meningitis and encephalitis. While HHV-8 is not typically associated with neurological diseases, several studies have indicated a relationship, such as secondary central nervous system (CNS) metastases and a few isolated cases of HHV-8 encephalitis in acquired immunodeficiency syndrome (HIV). However, it has not been previously linked to encephalitis in solid organ transplantation (SOT). This case presents the first-ever instance of HHV-8 encephalitis in a SOT recipient. Our case highlights the association of HHV-8-related diseases, such as post-transplant Kaposi's Sarcoma (KS), with encephalitis. The patient was diagnosed with KS before developing neurological symptoms and received a prompt clinical response through intravenous foscarnet and ganciclovir treatment for 14 days. It is important to note that HHV-8 is a rare cause of encephalitis, and diagnosis requires a high index of suspicion in the appropriate clinical context, allowing for the use of antiviral therapy. This case also underscores the importance of considering the possibility of HHV-8-related diseases in SOT recipients, as they are at risk of developing such infections.

Identifiants

pubmed: 39012412
doi: 10.1111/tid.14343
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e14343

Informations de copyright

© 2024 Wiley Periodicals LLC.

Références

Regamey N, Cathomas G. HHV‐8: a newly recognized pathogen in transplantation. Transplantation. 2000;69(9):1768–1769. https://journals.lww.com/transplantjournal/Fulltext/2000/05150/HHV_8__A_NEWLY_RECOGNIZED_PATHOGEN_IN.3.aspx
Parravicini C, Olsen SJ, Capra M, et al. Risk of Kaposi's sarcoma‐associated herpes virus transmission from donor allografts among Italian posttransplant Kaposi's sarcoma patients. Blood. 1997;90(7):2826–2829. https://pubmed.ncbi.nlm.nih.gov/9326251/
Vega F, Miranda RN, Jeffrey Medeiros L. KSHV/HHV8‐positive large B‐cell lymphomas and associated diseases: a heterogeneous group of lymphoproliferative processes with significant clinicopathological overlap. Modern Pathol. 2020;33(1):18–28. ISSN 0893–3952. doi:10.1038/s41379‐019‐0365‐y
Riva G, Luppi M, Barozzi P, et al. How I treat HHV8/KSHV‐related diseases in posttransplant patients? Blood. 2012;120(20):4150–4159. doi:10.1182/blood‐2012‐04‐421412
Mularoni A, Gallo A, Riva G, et al. Successful treatment of Kaposi sarcoma‐associated herpesvirus inflammatory cytokine syndrome after kidney–liver transplant: correlations with the human herpesvirus 8 miRNome and specific T cell response. Am J Transplant. 2017;17(11):2963–2969. ISSN 1600–6135. https://www.sciencedirect.com/science/article/pii/S1600613522252149
Henri A, Pascale B, Gautheret‐Dejean A. Human herpesviruses 6A, 6B, and 7. Am Soc Microbiol Microbiol Spectr. 2016;4. 1–6 doi:10.1128/microbiolspec.dmih2‐0007‐2015
Riva G, Barozzi P, Quadrelli C, et al. Human Herpesvirus 8 (HHV8) infection and related diseases in Italian transplant cohorts. Am J Transplant. 2013;13(6):1619–1620. ISSN 1600–6135. doi:10.1111/ajt.12225
Lebbe C, Porcher R, Marcelin AG, et al. Human Herpesvirus 8 (HHV8) transmission and related morbidity in organ recipients. Am J Transplant. 2013;13(1):207–213. ISSN 1600–6135. doi:10.1111/j.1600‐6143.2012.04290.x
Nocera A, Corbellino M, Valente U, et al. Posttransplant human herpes virus 8 infection and seroconversion in a kaposi's sarcoma affected kidney recipient transplanted from a human herpes virus 8 positive living related donor. Transplant Proc. 1998;30(5):2095–2096. ISSN 0041–1345. doi:10.1016/S0041‐1345(98)00550‐8
Chandra JH, Devan M, Jie Lu, et al. Gammaherpesvirus infection of human neuronal cells. Am Soc Microbiol. 2015;6. 1–6 doi:10.1128/mbio.01844‐15
For Yue Tso and others. Kaposi's Sarcoma‐associated herpesvirus infection of neurons in HIV‐positive patients. J Infect Dis. 2017;215(12):1898–1907. doi:10.1093/infdis/jiw545
Glaser CA, Honarmand S, Anderson LJ, et al. Beyond viruses: clinical profiles and etiologies associated with encephalitis. Clin Infect Dis. 2006;43(12):1565–1577, doi:10.1086/509330
Said JW, Tasaka T, Vos de S, et al. Kaposi's sarcoma‐associated herpesvirus/human herpesvirus type 8 encephalitis in HIV‐positive and ‐negative individuals. AIDS. 1997;11(9):1119–1122. doi:10.1097/00002030‐199709000‐00006
Luppi M, Barozzi P, Schulz TF, et al. Bone marrow failure associated with human herpesvirus 8 infection after transplantation. N Engl J Med. 2000;343:1378–1385. doi:10.1056/NEJM200011093431905
Medveczky MM, Horvath E, Lund T, et al. In vitro antiviral drug sensitivity of the Kaposi's sarcoma‐associated herpesvirus. AIDS. 1997;11(11):1327–1332. http://www.ncbi.nlm.nih.gov/pubmed/9302441
Luppi M, Barozzi P, Rasini V, et al. Severe pancytopenia and hemophagocytosis after HHV‐8 primary infection in a renal transplant patient successfully treated with foscarnet. Transplantation. 2002;74(1):131–132. http://www.ncbi.nlm.nih.gov/pubmed/12134112

Auteurs

Inderjit Mann (I)

Department of Infectious Diseases, Infection Control and Employee Health, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Oscar Morado-Aramburo (O)

Section of Infectious Diseases, UT Health McGovern Medical School, Houston, Texas, USA.

Rodrigo Hasbun (R)

Section of Infectious Diseases, UT Health McGovern Medical School, Houston, Texas, USA.

Classifications MeSH