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Detection of human herpesvirus-6 in cerebrospinal fluid of patients with encephalitis
Karen Yao1, Somayeh Honarmand, Alex Espinosa
1Viral Immunology Section, Neuroimmunology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA.
Objective:
Virus infections are the most common causes of encephalitis, a syndrome characterized by acute inflammation of the brain. More than 150 different viruses have been implicated in the pathogenesis of encephalitis; however, because of limitations with diagnostic testing, causative factors of more than half of the cases remain unknown.
Methods:
To investigate whether human herpesvirus-6 (HHV-6) is a causative agent of encephalitis, we examined for evidence of virus infection by determining the presence of viral sequence using polymerase chain reaction and assessed HHV-6 antibody reactivity in the cerebrospinal fluid of encephalitis patients with unknown cause. In a cohort study, we compared virus-specific antibody levels in cerebrospinal fluid samples of patients with encephalitis, relapsing-remitting multiple sclerosis, and other neurological diseases.
Results:
Our results demonstrated increased levels of HHV-6 IgG, as well as IgM levels, in a subset of encephalitis patients compared with other neurological diseases. Moreover, cell-free viral DNA that is indicative of active infection was detected in 40% (14/35) of encephalitis patients, whereas no amplifiable viral sequence was found in either relapsing-remitting MS or other neurological diseases patients. In addition, a significant correlation between polymerase chain reaction detection and anti-HHV-6 antibody response was also demonstrated.
Interpretation:
Collectively, these results suggested HHV-6 as a possible pathogen in a subset of encephalitis cases.
Insights
Human herpesvirus-6 (HHV-6) may cause encephalitis, a brain inflammation. Researchers found HHV-6 DNA and antibodies in some encephalitis patients, suggesting it as a potential pathogen.
Area of Science:
- Neurology
- Virology
- Infectious Diseases
Background:
- Virus infections are primary causes of encephalitis, leading to acute brain inflammation.
- The causative agents for over half of encephalitis cases remain unidentified due to diagnostic limitations.
Purpose of the Study:
- To investigate the role of human herpesvirus-6 (HHV-6) as a potential cause of encephalitis.
- To determine if HHV-6 is present in patients with unexplained encephalitis.
Main Methods:
- Examined cerebrospinal fluid (CSF) from encephalitis patients for HHV-6 DNA using polymerase chain reaction (PCR).
- Assessed HHV-6 specific antibody (IgG and IgM) levels in CSF.
- Compared findings with CSF samples from patients with multiple sclerosis and other neurological diseases.
Main Results:
- Elevated HHV-6 IgG and IgM antibodies were detected in a subset of encephalitis patients.
- Cell-free viral DNA, indicating active infection, was found in 40% of encephalitis patients.
- A significant correlation was observed between PCR detection of HHV-6 and the presence of anti-HHV-6 antibodies.
Conclusions:
- Human herpesvirus-6 (HHV-6) is suggested as a potential pathogen in some cases of encephalitis.
- These findings highlight the importance of considering HHV-6 in the differential diagnosis of encephalitis.
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