title: Human herpesvirus 6 reactivation and inflammatory cytokine production in patients with drug-induced hypersensitivity syndrome.
abstract: BACKGROUND
  Human herpesvirus 6 (HHV-6) reactivation has been suggested to modify the clinical features of drug induced hypersensitivity syndrome (DIHS). However, mechanisms for viral reactivation and modification of the clinical features remain unclear.
  
  
  OBJECTIVE
  To determine whether cytokines play an important role in viral reactivation and modification of the clinical features.
  
  
  METHODS
  We examined the kinetics of serum cytokines and viral load in HHV-6 infections of six patients with DIHS.
  
  
  RESULTS
  HHV-6 infection occurred three to four weeks after the onset of disease. Elevated TNF-alpha and IL-6 levels were observed to precede HHV-6 infection in four of the six patients. Although high levels of IL-6 were observed in samples collected prior to HHV-6 infection, the amounts of this cytokine significantly decreased to undetectable levels during viral infection in five of the six patients. Subsequently, serum IL-6 levels were increased after viral infection in five patients. IL-1beta levels were also increased at the time of viral infection in three of the six patients. Neither IL-4 nor IFN-gamma could be detected in any of the samples.
  
  
  CONCLUSIONS
  These results demonstrate that cytokines play an important role in HHV-6 reactivation in patients with DIHS.
authors.affiliation: Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan. tetsushi@fujita-hu.ac.jp
authors.forename: Tetsushi
authors.initials: T
authors.lastname: Yoshikawa
authors.forename: Ayano
authors.initials: A
authors.lastname: Fujita
authors.forename: Akiko
authors.initials: A
authors.lastname: Yagami
authors.forename: Kayoko
authors.initials: K
authors.lastname: Suzuki
authors.forename: Kayoko
authors.initials: K
authors.lastname: Matsunaga
authors.forename: Masaru
authors.initials: M
authors.lastname: Ihira
authors.forename: Yoshizo
authors.initials: Y
authors.lastname: Asano
mesh_terms: D000328:Adult; D000368:Aged; D016207:Cytokines / Q000096:biosynthesis* / Q000097:blood; D004342:Drug Hypersensitivity / Q000150:complications*; D015654:Herpesvirus 6, Human / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019349:Roseolovirus Infections / Q000276:immunology* / Q000821:virology; D019562:Viral Load; D014775:Virus Activation
chemical_list: D016207:Cytokines