Abstract
This study investigated factors associated with the development of human herpesvirus (HHV)-6 encephalitis. Among 111 enrolled subjects, 12 patients developed central nervous system (CNS) dysfunction. CNS dysfunction in four patients was found to have no association with HHV-6. The remaining eight patients displayed HHV-6 encephalitis (n=3), limbic encephalitis (HHV-6 DNA in cerebrospinal fluid was not examined; n=3) or CNS dysfunction because of an unidentified cause (n=2). Real-time PCR showed CNS dysfunction in the latter eight patients, which developed concomitant with the appearance of high plasma levels of HHV-6 DNA (⩾104 copies/ml). Overall, eight of the 24 patients with high-level HHV-6 DNA developed CNS dysfunction, whereas no patients developed CNS dysfunction potentially associated with HHV-6 infection if peak HHV-6 DNA was <104 copies/ml. We next analyzed plasma concentrations of IL-6, IL-10 and tumor necrosis factor-α among patients who displayed high-level plasma HHV-6 DNA and found elevated IL-6 concentrations preceding HHV-6 infection in patients who developed CNS dysfunction. (Mean±s.d.: 865.7±1036.3 pg/ml in patients with CNS dysfunction; 56.5±192.9 pg/ml in others; P=0.01). These results suggest that high-level HHV-6 load is necessary for the development of HHV-6 encephalitis, and systemic inflammatory conditions before HHV-6 infection form the preparatory conditions for progression to encephalopathy.
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Acknowledgements
This study was presented in part at the Sixth International Conference on HHV-6&7 in Baltimore, MD, USA on 19–22 June 2008. The financial support was provided by Oita University Faculty of Medicine; Ministry of Education, Culture, Sports, Science and Technology of Japan (Grant-in-Aid for Scientific Research 17015047).
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Ogata, M., Satou, T., Kawano, R. et al. Correlations of HHV-6 viral load and plasma IL-6 concentration with HHV-6 encephalitis in allogeneic stem cell transplant recipients. Bone Marrow Transplant 45, 129–136 (2010). https://doi.org/10.1038/bmt.2009.116
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DOI: https://doi.org/10.1038/bmt.2009.116
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