HHV-6A in syncytial giant-cell hepatitis.
Syncytial giant-cell hepatitis is a rare but severe form of hepatitis that is associated with autoimmune diseases, drug reactions, and viral infections. We used serologic, molecular, and immunohistochemical methods to search for an infectious cause in a case of syncytial giant-cell hepatitis that developed in a liver-transplant recipient who had latent infection with variant B of human herpesvirus 6 (HHV-6B) and who had received the organ from a donor with variant A latent infection (HHV-6A). At the onset of the disease, the detection of HHV-6A (but not HHV-6B) DNA in plasma, in affected liver tissue, and in single micromanipulated syncytial giant cells with the use of two different polymerase-chain-reaction (PCR) assays indicated the presence of active HHV-6A infection in the patient. Expression of the HHV-6A-specific early protein, p41/38, but not of the HHV-6B-specific late protein, p101, was demonstrated only in liver syncytial giant cells in the absence of other infectious pathogens. The same markers of HHV-6A active infection were documented in serial follow-up samples from the patient and disappeared only at the resolution of syncytial giant-cell hepatitis. Neither HHV-6B DNA nor late protein was identified in the same follow-up samples from the patient. Thus, HHV-6A may be a cause of syncytial giant-cell hepatitis.
Potenza
Leonardo
L
Department of Oncology and Hematology, University of Modena and Reggio Emilia, Azienda Ospedaliera Policlinico, Modena, Italy.
Luppi
Mario
M
Barozzi
Patrizia
P
Rossi
Giulio
G
Cocchi
Stefania
S
Codeluppi
Mauro
M
Pecorari
Monica
M
Masetti
Michele
M
Di Benedetto
Fabrizio
F
Gennari
William
W
Portolani
Marinella
M
Gerunda
Giorgio Enrico
GE
Lazzarotto
Tiziana
T
Landini
Maria Paola
MP
Schulz
Thomas F
TF
Torelli
Giuseppe
G
Guaraldi
Giovanni
G
D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D016767:Caroli Disease / Q000601:surgery*; D004279:DNA, Viral / Q000097:blood; D018562:Disease Transmission, Infectious; D015726:Giant Cells; D005938:Glucocorticoids / Q000627:therapeutic use; D006084:Graft Rejection; D006505:Hepatitis / Q000188:drug therapy / Q000473:pathology / Q000821:virology*; D015654:Herpesvirus 6, Human / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D008099:Liver / Q000473:pathology; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D009894:Opportunistic Infections / Q000150:complications; D019349:Roseolovirus Infections / Q000150:complications* / Q000635:transmission; D019562:Viral Load; D017735:Virus Latency
D000914:Antibodies, Viral; D004279:DNA, Viral; D005938:Glucocorticoids