title: Detection of active human herpesvirus-6 infection in the brain: correlation with polymerase chain reaction detection in cerebrospinal fluid.
abstract: One-half of bone-marrow transplant (BMT) and stem-cell transplant recipients have reactivation of latent human herpesvirus (HHV)-6 2-4 weeks after transplant. Although the detection of viral DNA, RNA, and antigen in brain material confirmed active HHV-6 variant B infection, peak viral loads in cerebrospinal fluid (CSF) and serum occurred 2-4 weeks before death and decreased to low levels before or at autopsy. All autopsy samples consistently demonstrated HHV-6 active infection in the hippocampus. Astrocytic cells positive for viral antigen provided support for an HHV-6-specific tropism for hippocampal astrocytes. HHV-6 DNA in CSF and serum may not reflect the level of active viral infection in the brain after BMT.
authors.affiliation: Viral Immunology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA.
authors.forename: Julie
authors.initials: J
authors.lastname: Fotheringham
authors.forename: Nahid
authors.initials: N
authors.lastname: Akhyani
authors.forename: Alexander
authors.initials: A
authors.lastname: Vortmeyer
authors.forename: Donatella
authors.initials: D
authors.lastname: Donati
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Williams
authors.forename: Unsong
authors.initials: U
authors.lastname: Oh
authors.forename: Michael
authors.initials: M
authors.lastname: Bishop
authors.forename: John
authors.initials: J
authors.lastname: Barrett
authors.forename: Juan
authors.initials: J
authors.lastname: Gea-Banacloche
authors.forename: Steven
authors.initials: S
authors.lastname: Jacobson
mesh_terms: D000956:Antigens, Viral / Q000302:isolation & purification; D001253:Astrocytes / Q000821:virology; D016026:Bone Marrow Transplantation; D001927:Brain Diseases / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D004279:DNA, Viral / Q000097:blood / Q000134:cerebrospinal fluid; D004268:DNA-Binding Proteins / Q000235:genetics / Q000302:isolation & purification; D003643:Death; D015654:Herpesvirus 6, Human / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D006624:Hippocampus / Q000166:cytology / Q000821:virology*; D006801:Humans; D007150:Immunohistochemistry; D007963:Leukocytes, Mononuclear; D016133:Polymerase Chain Reaction; D011183:Postoperative Complications; D012333:RNA, Messenger / Q000032:analysis; D012367:RNA, Viral / Q000032:analysis; D019349:Roseolovirus Infections / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D014764:Viral Proteins / Q000235:genetics / Q000302:isolation & purification
chemical_list: D000956:Antigens, Viral; D004279:DNA, Viral; D004268:DNA-Binding Proteins; D012333:RNA, Messenger; D012367:RNA, Viral; D014764:Viral Proteins; C081690:p41 protein, Human herpesvirus 6