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Fulminant human herpesvirus six encephalitis in a human immunodeficiency virus-infected infant
K K Knox1, D P Harrington, D R Carrigan
1Department of Pathology, Medical College of Wisconsin, Milwaukee 53226, USA.
Insights
Human herpesvirus six (HHV-6) can cause central nervous system (CNS) issues in children. This study details a severe HHV-6 encephalitis case in an HIV-infected infant, highlighting invasive disease potential.
Area of Science:
- Virology
- Neurology
- Immunology
Background:
- Human herpesvirus six (HHV-6) primary infection commonly causes self-limited central nervous system (CNS) involvement in children.
- Human immunodeficiency virus (HIV) infection can alter the course of common viral infections.
Observation:
- An HIV-infected infant presented with severe, fulminant encephalitis.
- Immunohistochemical staining revealed widespread productive HHV-6 infection across all CNS cell types.
Findings:
- Polymerase chain reaction (PCR) analysis confirmed a dense HHV-6 infection in the infant's brain tissue.
- The predominant HHV-6 variant identified in the CNS tissue was variant A.
Implications:
- This case represents the first documented instance of invasive HHV-6 tissue disease in an HIV-infected infant.
- Findings suggest HHV-6 variant A may play a significant role in severe CNS disease in immunocompromised infants.
- Highlights the need for vigilance regarding HHV-6 infections in HIV-infected infants, especially those with neurological symptoms.
Abstract:
Self-limited involvement of the central nervous system (CNS) is a relatively common complication of primary infection with human herpesvirus six (HHV-6) in normal children. We describe an HIV-infected infant who developed fulminant encephalitis as a complication of HHV-6 infection. Immunohistochemical staining of CNS tissue demonstrated productive infection of all CNS cell-types. Analysis of the infected brain tissue by the polymerase chain reaction (PCR) confirmed the presence of a dense HHV-6 infection in the tissue, and demonstrated that the virus present in the CNS tissue was predominantly the A variant of HHV-6. This is the first demonstration of invasive tissue disease caused by HHV-6 in an HIV-infected infant.