title: Fatal adult case of severe lymphocytopenia associated with reactivation of human herpesvirus 6.
abstract: It has been suggested that immunosuppression associated with human herpesvirus 6 (HHV-6) infection is a result of functional impairment or direct destruction of immunological cells. The ability of the virus to infect and destroy lymphocytes may cause progressive immunodeficiency in an infant with primary HHV-6 infection. An adult patient is described who had a fatal cytomegalovirus (CMV) infection due to severe and prolonged lymphocyte depletion associated with HHV-6 reactivation. The HHV-6 antibody titers were increased significantly after reactivation, and the virus was isolated from his peripheral blood mononuclear cells. The quantity of both HHV-6 and CMV DNA was determined by using real-time PCR in plasma samples collected serially. HHV-6 DNAemia persisted for 1 month, which started just 1 week after the onset of lymphocytopenia. In contrast to HHV-6, CMV DNAemia was detected in the terminal phase of the illness. Thus, HHV-6 reactivation may have been the cause of the severe lymphocyte depletion and fatal CMV infection.
authors.affiliation: Laboratory of Virology, Research Institute for Disease Mechanism and Control, Nagoya University School of Medicine, Nagoya, Japan. tetsushi@med.nagoya-u.ac.jps
authors.forename: Tetsushi
authors.initials: T
authors.lastname: Yoshikawa
authors.forename: Masaru
authors.initials: M
authors.lastname: Ihira
authors.forename: Yoshizo
authors.initials: Y
authors.lastname: Asano
authors.forename: Akiko
authors.initials: A
authors.lastname: Tomitaka
authors.forename: Kayoko
authors.initials: K
authors.lastname: Suzuki
authors.forename: Kayoko
authors.initials: K
authors.lastname: Matsunaga
authors.forename: Yasuchika
authors.initials: Y
authors.lastname: Kato
authors.forename: Sinya
authors.initials: S
authors.lastname: Hiramitsu
authors.forename: Tomohito
authors.initials: T
authors.lastname: Nagai
authors.forename: Naoko
authors.initials: N
authors.lastname: Tanaka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kimura
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Nishiyama
mesh_terms: D000368:Aged; D003587:Cytomegalovirus / Q000235:genetics / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000209:etiology*; D017809:Fatal Outcome; D015654:Herpesvirus 6, Human / Q000235:genetics / Q000254:growth & development* / Q000302:isolation & purification; D006801:Humans; D008231:Lymphopenia / Q000209:etiology*; D008297:Male; D019349:Roseolovirus Infections / Q000150:complications*; D014775:Virus Activation