title: HHV-6A in syncytial giant-cell hepatitis.
abstract: 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.
authors.affiliation: Department of Oncology and Hematology, University of Modena and Reggio Emilia, Azienda Ospedaliera Policlinico, Modena, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Potenza
authors.forename: Mario
authors.initials: M
authors.lastname: Luppi
authors.forename: Patrizia
authors.initials: P
authors.lastname: Barozzi
authors.forename: Giulio
authors.initials: G
authors.lastname: Rossi
authors.forename: Stefania
authors.initials: S
authors.lastname: Cocchi
authors.forename: Mauro
authors.initials: M
authors.lastname: Codeluppi
authors.forename: Monica
authors.initials: M
authors.lastname: Pecorari
authors.forename: Michele
authors.initials: M
authors.lastname: Masetti
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Di Benedetto
authors.forename: William
authors.initials: W
authors.lastname: Gennari
authors.forename: Marinella
authors.initials: M
authors.lastname: Portolani
authors.forename: Giorgio Enrico
authors.initials: GE
authors.lastname: Gerunda
authors.forename: Tiziana
authors.initials: T
authors.lastname: Lazzarotto
authors.forename: Maria Paola
authors.initials: MP
authors.lastname: Landini
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Schulz
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Torelli
authors.forename: Giovanni
authors.initials: G
authors.lastname: Guaraldi
mesh_terms: 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
chemical_list: D000914:Antibodies, Viral; D004279:DNA, Viral; D005938:Glucocorticoids