RESUMEN
BACKGROUND: Clinical manifestations of human herpesvirus-6 (HHV-6) have not been clearly defined, and the role of HHV-6 in human disease remains to be fully elucidated. OBJECTIVE: To determine the frequency of HHV-6 infections at Rennes Teaching Hospital and to describe all possible symptoms of such infections. STUDY DESIGN: We systematically analyzed in a retrospective study all the samples between May 2003 and December 2004 from patients with HHV-6 by polymerase chain reaction (PCR). Clinical records of patients with positive HHV-6 PCR were recorded. Diagnosis of HHV-6 infection was accepted if all other possible diagnoses had been eliminated. RESULTS: Over the study period, 1591 PCRs were performed from various tissues, including blood, cerebrospinal fluid, ascitis and tissue biopsies. Forty-three samples from 25 patients tested positive (3%). We describe three groups of clinical manifestations of HHV-6 infection. The first group consisted of neurological complications (32% of patients), including convulsions, encephalitis and chronic psychiatric disorders in immunocompetent patients. The second group consisted of clinical problems relating to gastrointestinal tract, which was found in 9 of our patients (36%). All of these patients were immunocompromised. Four of them presented colitis, and one of them died one month after liver transplantation because of this colitis. The last group of clinical symptoms was associated with maternal-fetal infection leading to abortion following HHV-6 seroconversion during pregnancy. CONCLUSION: Three clinical types of HHV-6 infections are described: neurological manifestations including encephalitis in non-immunocompromised patients, digestive problems in immunosuppressed patients and severe maternal-fetal infection.
Asunto(s)
Herpesvirus Humano 6/aislamiento & purificación , Infecciones por Roseolovirus/clasificación , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Preescolar , ADN Viral/sangre , ADN Viral/líquido cefalorraquídeo , Enfermedades del Sistema Digestivo/virología , Encefalitis Viral/virología , Femenino , Enfermedades Fetales/virología , Herpesvirus Humano 6/genética , Herpesvirus Humano 6/patogenicidad , Humanos , Inmunocompetencia , Huésped Inmunocomprometido , Lactante , Recién Nacido , Enfermedades del Recién Nacido/virología , Transmisión Vertical de Enfermedad Infecciosa , Masculino , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa/métodos , Embarazo , Complicaciones Infecciosas del Embarazo/virología , Estudios Retrospectivos , Infecciones por Roseolovirus/virologíaRESUMEN
The features of a characteristic type of encephalopathy caused by human herpesvirus-6 are presented. All patients have clusters of brief convulsions during the stage of skin eruptions. Sometimes the encephalopathy resulted in hemiplegia or mental retardation. Because the clinical course is similar, we propose a subtype of encephalopathy "human herpesvirus-6 encephalopathy with cluster of convulsions in eruptive stage" for further studies of pathophysiology and treatment.