Human Herpes Virus 6 and Encephalitis in Children
Keywords:
Human herpesvirus 6, fever, seizure, encephalitis, immunocompetent
Abstract
Abstract
Human herpesvirus 6 was the sixth herpesvirus discovered, it is a beta-herpesvirus and is ubiquitous in nature. Primary infection with HHV-6 occurs within the first 2 years of life and is usually associated with an undifferentiated febrile illness, although a subset of children exhibit the classic manifestations of roseola infantum. After primary infection, the virus replicates in salivary glands and is shed in saliva, the recognized route of transmission. It remains latent in lymphocytes and monocytes and persists at low levels in cells and tissues. HHV-6 is probably the most neurotropic virus known, it has been implicated as a cause of encephalitis in transplant recipients but occasionally is reported as a cause of meningitis and encephalitis in immunocompetent individuals. We present the case of a 21-month old infant diagnosed with HHV-6 encephalitis.
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References
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[2] Bagdure D, Custer JW, Rao S, et al. Hospitalized Children With Encephalitis in the United States: A Pediatric Health Information System Database Study. Pediatric neurology. 2016;61:58–62. [PubMed] [Google Scholar]
[3] Braun DK, Dominguez G, Pellett PE. Human herpesvirus 6, Clin Microbiol Rev, 1997, vol. 10 (pg. 521-67)Google ScholarPubMed
[4] Britton PN, Dale RC, Booy R, Jones CA. Acute encephalitis in children: Progress and priorities from an Australasian perspective. J Paediatr Child Health. 2015;51(2):147–158. [PubMed] [Google Scholar]
[5] Campadelli-Fiume G, Mirandola P, Menotti L. Human herpesvirus 6: an emerging pathogen, Emerg Infect Dis, 1999, vol. 5 (pg. 353-66)Google ScholarCrossrefPubMed
[6] Caserta MT, Hall CB, Schnabel K, et al. Neuroinvasion and persistence of human herpesvirus 6 in children, J Infect Dis, 1994, vol. 170 (pg. 1586-9)Google ScholarCrossrefPubMed
[7] Cuomo L, Trivedi P, Cardillo MR, et al. Human herpesvirus 6 infection in neoplastic and normal brain tissue, J Med Virol, 2001, vol. 63 (pg. 45-51) Google ScholarCrossrefPubMed
[8] Fairfax MR, Schacker T, Cone RW, Collier AC, Corey L. Human herpesvirus 6 DNA in blood cells of human immunodeficiency virusinfected men: correlation of high levels with high CD4 cell counts, J Infect Dis, 1994, vol. 169 (pg. 1342-5) Google ScholarCrossrefPubMed
[9] Flamand L, Stefanescu I, Menezes J. Human herpesvirus-6 enhances natural killer cell cytotoxicity via IL-15, J Clin Invest, 1996, vol. 97 (pg. 1373-81) Google ScholarCrossrefPubMed
[10] Flett KB, Rao S, Dominguez SR, Bernard T, Glode MP. Variability in the Diagnosis of Encephalitis by Pediatric Subspecialists: The Need For a Uniform Definition. J Pediatric Infect Dis Soc. 2013;2(3):267–269. [PubMed] [Google Scholar]
[11] George BP, Schneider EB, Venkatesan A. Encephalitis hospitalization rates and inpatient mortality in the United States, 2000–2010. PloS one. 2014;9(9):e104169. [PMC free article] [PubMed] [Google Scholar]
[12] Griffiths PD, Clark DA, Emery VC. Betaherpesviruses in transplant recipients, J Antimicrob Chemother, 2000, vol. 45 (pg. 29-34) Google ScholarCrossrefPubMed
[13] Hall CB, Long CE, Schnabel KC, et al. Human herpesvirus-6 infection in children: a prospective study of complications and reactivation, N Engl J Med, 1994, vol. 331 (pg. 432-8) Google ScholarCrossrefPubMed
[14] Iro MA, Sadarangani M, Goldacre R, Nickless A, Pollard AJ, Goldacre MJ. 30- year trends in admission rates for encephalitis in children in England and effect of improved diagnostics and measles-mumps-rubella vaccination: a population-based observational study. The Lancet Infectious diseases. 2017 [PubMed] [Google Scholar]
[15] Jee SH, Long CE, Schnabel KC, et al. Risk of recurrent seizures after a primary human herpesvirus 6—induced febrile seizure, Pediatr Infect Dis J, 1998, vol. 17 (pg. 43-8) Google ScholarCrossrefPubMed
[16] Kestenbaum LA, Ebberson J, Zorc JJ, Hodinka RL, Shah SS. Defining cerebrospinal fluid white blood cell count reference values in neonates and young infants. Pediatrics. 2010;125(2):257–264. [PMC free article] [PubMed] [Google Scholar]
[17] Kositanont U, Wasi C, Wanprapar N, et al. Primary infection of human herpesvirus 6 in children with vertical infection of human immunodeficiency virus type 1, J Infect Dis, 1999, vol. 180 (pg. 50-5) Google ScholarCrossrefPubMed
[18] Knox KK, Carrigan DR. Disseminated active HHV-6 infections in patients with AIDS, Lancet, 1994, vol. 343 (pg. 577-8) Google ScholarCrossrefPubMed
[19] Lewis P, Glaser CA. Encephalitis. Pediatrics in review / American Academy of Pediatrics. 2005;26(10):353–363. [PubMed] [Google Scholar]
[20] Lusso P, Malnati M, De Maria A, et al. Productive infection of CD4+ and CD8+ mature human T cell populations and clones by human herpesvirus 6: transcriptional down-regulation of CD3, J Immunol, 1991, vol. 147 (pg. 685-91) Google ScholarPubMed
[21] Lusso P, De Maria A, Malnati M, et al. Induction of CD4 and susceptibility to HIV-1 infection in human CD8+ T lymphocytes by human herpesvirus 6, Nature, 1991, vol. 349 (pg. 533-5) Google ScholarCrossrefPubMed
[22] McCullers JA, Lakeman FD, Whitley RJ. Human herpesvirus 6 is associated with focal encephalitis., Clin Infect Dis, 1995, vol. 21 (pg. 571-6) Google ScholarCrossrefPubMed
[23] Pahud BA, Glaser CA, Dekker CL, Arvin AM, Schmid DS. Varicella zoster disease of the central nervous system: epidemiological, clinical, and laboratory features 10 years after the introduction of the varicella vaccine. The Journal of infectious diseases. 2011;203(3):316–323. [PMC free article] [PubMed] [Google Scholar]
[24] Pruksananonda P, Hall CB, Insel RA, et al. Primary human herpesvirus 6 infection in young children, N Engl J Med, 1992, vol. 326 (pg. 1445-50) Google ScholarCrossrefPubMed
[25] Renaud C, Harrison CJ. Human Parechovirus 3: The Most Common Viral Cause of Meningoencephalitis in Young Infants. Infect Dis Clin North Am. 2015;29(3):415–428. [PubMed] [Google Scholar]
[26] Santoro F, Kennedy PE, Locatelli G, et al. CD46 is a cellular receptor for human herpesvirus 6, Cell, 1999, vol. 99 (pg. 817-27) Google ScholarCrossrefPubMed
[27] Seiden JA, Zorc JJ, Hodinka RL, Shah SS. Lack of cerebrospinal fluid pleocytosis in young infants with enterovirus infections of the central nervous system. Pediatr Emerg Care. 2010;26(2):77–81. [PubMed] [Google Scholar]
[28] Singh N, Paterson DL. Encephalitis caused by human herpesvirus-6 in transplant recipients: relevance of a novel neurotropic virus, Transplantation, 2000, vol. 69 (pg. 2474-9) Google ScholarCrossrefPubMed
[29] Suga S, Yoshikawa T, Asano Y, et al. Clinical and virological analyses of 21 infants with exanthem subitum (roseola infantum) and central nervous system complications, Ann Neurol, 1993, vol. 33 (pg. 597-603) Google ScholarCrossrefPubMed
[30] Tunkel AR, Glaser CA, Bloch KC, et al. The management of encephalitis: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis. 2008;47(3):303–327. [PubMed] [Google Scholar]
[31] Venkatesan A, Tunkel AR, Bloch KC, et al. Case definitions, diagnostic algorithms, and priorities in encephalitis: consensus statement of the international encephalitis consortium. Clin Infect Dis. 2013;57(8):1114–1128. [PMC free article] [PubMed] [Google Scholar]
[32] Yamanishi K, Okuno T, Shiraki K, et al. Identification of human herpesvirus-6 as a causal agent for exanthem subitum, Lancet, 1988, vol. 1 (pg. 1065-7) Google ScholarCrossrefPubMed
Published
2021-03-02
How to Cite
Elda Skenderi, Gjeorgjina Kuli-Lito, Admir Sulovari, Nilsa Shahini, Griselda Toci, & Ada Pema. (2021). Human Herpes Virus 6 and Encephalitis in Children. IJRDO -JOURNAL OF HEALTH SCIENCES AND NURSING, 6(2), 44-48. https://doi.org/10.53555/hsn.v6i2.4065
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