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HHV-6A reactivation in a ciHHV-6A transplant patient with encephalitis; experts stress the importance of further study

Experts from one of the leading stem cell transplant centers, the Fred Hutchinson Cancer Research Center at the University of Washington, have reported a case of ciHHV6A reactivation in a patient who developed CNS dysfunction and HHV-6A encephalitis after receiving a hematopoietic cell transplant (HCT).  The authors of the study believe these findings are best explained by ciHHV-6A reactivation, and emphasize the need for large multicenter collaborations to determine the impact of ciHHV-6 on patient outcomes. READ MORE

Could a novel free radical scavenger improve outcome in HHV-6 induced encephalopathy?

Edaravone, a free radical scavenging drug clinically used in Japan to treat acute ischemic stroke, was shown to be partially effective in managing a small group of patients with HHV-6 encephalopathy. A collaborative group from Tokyo tested the impact of this drug on a subset of encephalopathy cases recently identified to be associated with HHV-6. The subset is characterized by an initial febrile seizure followed by secondary seizures, most often a cluster of complex seizures on days 4-6. The Tokyo group treated 6 patients with edaravone in addition to conventional therapy, 5 with HHV-6 encephalopathy and 1 with HHV-6 complex FS. The CSF levels of 8-OHdG in these patients decreased after treatment with edaravone, suggesting that edaravone may have been partially effective in treating HHV-6–associated encephalopathy. READ MORE

HHV-6 and EBV (but not CMV) elevated in the GI tract of HIV+ patients

A group from Sapienza University in Rome has found significantly elevated prevalence of HHV-6 and viral load of EBV in the stomach and duodenum biopsies of patients with HIV compared to controls, suggesting that these viruses may contribute to the development of gastric cancer in immunocompromised patients. READ MORE

New findings characterize immune response to HHV-6; advance the field of adoptive immunotherapy

Dr. Louis Flamand’s group has published new details regarding the recognition and presentation of HHV-6 proteins by the immune system.  Their work has identified CD8+ T cell viral epitopes derived from the HHV-6B immediate early protein (IE1B) that are then presented by common HLA class 1 alleles.  While T cell immunotherapy can successfully control cytomegalovirus (CMV) and Epstein-Barr virus (EBV) reactivations in BMT patients, this technique has not yet been optimized for managing HHV-6 infections, in part due to a lack of identified protective CD8+ T cell epitopes.  The findings presented in this report will help advance this field, providing key steps toward the effective treatment and/or prevention of HHV-6 reactivation in BMT recipients. READ MORE

Elevated MMP-9 & TIMP-1 are highly elevated in patients with HHV-6 viremia: the link to HHV-6 associated febrile seizures?

A group led by Takashi Ichiyama has determined that serum levels of both matrix metallopreinase-9 (MMP-9) and tissue inhibitor of metalloproeinases-1 (TIMP-1) are significantly elevated in infants with HHV-6 infection compared to controls (P<0.05). The authors propose that the HHV-6 induced elevation in enzymes may cause dysfunction of the blood brain barrier, eventually leading to febrile seizures. READ MORE

HHV-6 reactivation with status epilepticus and hyponatremia after transplantation

A report published by a group from the University of Minnesota details the case of a 59-year-old male who developed non-convulsive status epilepticus and hyponatremia in addition to HHV-6 reactivation following umbilical cord blood transplantation. Low serum sodium values following transplantation may be indicative of HHV-6 reactivation and/or incipient encephalitis. READ MORE