Fatal adult case of severe lymphocytopenia associated with reactivation of human herpesvirus 6.
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.
Yoshikawa
Tetsushi
T
Laboratory of Virology, Research Institute for Disease Mechanism and Control, Nagoya University School of Medicine, Nagoya, Japan. tetsushi@med.nagoya-u.ac.jps
Ihira
Masaru
M
Asano
Yoshizo
Y
Tomitaka
Akiko
A
Suzuki
Kayoko
K
Matsunaga
Kayoko
K
Kato
Yasuchika
Y
Hiramitsu
Sinya
S
Nagai
Tomohito
T
Tanaka
Naoko
N
Kimura
Hiroshi
H
Nishiyama
Yukihiro
Y
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