PMID- 17516535
OWN - NLM
STAT- MEDLINE
DCOM- 20070807
LR  - 20070528
IS  - 0146-6615 (Print)
IS  - 0146-6615 (Linking)
VI  - 79
IP  - 7
DP  - 2007 Jul
TI  - Human herpesvirus 6-associated retrobulbar optic neuritis in an HIV-infected 
      patient: response to anti-herpesvirus therapy and long-term outcome.
PG  - 931-4
AB  - Like other herpesviruses, human herpesvirus 6 (HHV-6) can reactivate in 
      immunocompromised patients. A case is described of an HIV-1-infected patient who 
      developed bilateral retrobulbar optic neuritis associated with HHV-6 infection. A 
      59-year-old woman, infected with HIV for 18 years, interrupted antiretroviral 
      treatment because of therapeutic failure and severe metabolic complications. She 
      presented subsequently with blurred vision and ophthalmological examination 
      showed visual loss due to optic neuritis. Her CD4+ count was 285 cells/mm(3) and 
      her plasma HIV-1 RNA level was 5.5 log(10) copies (cp)/ml. Magnetic resonance 
      imaging of the brain was normal. HHV-6 loads were 3.2 log cp/ml in cerebrospinal 
      fluid (CSF) and 6.3 log cp/10(6) peripheral blood mononuclear cells. Combined 
      intravenous treatment was started with foscarnet and ganciclovir then changed to 
      cidofovir and long-term valganciclovir. Her ocular condition improved gradually 
      despite little decrease of the HHV-6 load in the CSF. Salvage antiretroviral 
      treatment was then administered, with marked immunological and virological 
      responses, contributing to further progressive ocular improvement. HHV-6-related 
      optic neuritis has not been described previously in HIV-infected patients. 
      Anti-HHV-6 treatment improved the patient's vision, but immune restoration seems 
      to remain essential for long-term recovery.
FAU - Mechai, Frederic
AU  - Mechai F
AD  - Department of Internal Medicine and Infectious Diseases, Bicetre University 
      Hospital, Le Kremlin Bicetre Cedex, France. mechaifrederic@wanadoo.fr
FAU - Boutolleau, David
AU  - Boutolleau D
FAU - Manceron, Veronique
AU  - Manceron V
FAU - Gasnault, Jacques
AU  - Gasnault J
FAU - Quertainmont, Yann
AU  - Quertainmont Y
FAU - Brosseau, Jean-Paul
AU  - Brosseau JP
FAU - Delfraissy, Jean-Francois
AU  - Delfraissy JF
FAU - Labetoulle, Marc
AU  - Labetoulle M
FAU - Goujard, Cecile
AU  - Goujard C
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - J Med Virol
JT  - Journal of medical virology
JID - 7705876
RN  - 0 (Antiviral Agents)
SB  - IM
MH  - AIDS-Related Opportunistic Infections/*drug therapy/virology
MH  - Antiviral Agents/*therapeutic use
MH  - Cerebrospinal Fluid/virology
MH  - Female
MH  - HIV-1
MH  - Herpesvirus 6, Human/isolation & purification/*pathogenicity
MH  - Humans
MH  - Middle Aged
MH  - Optic Neuritis/*complications/*drug therapy/virology
MH  - Roseolovirus Infections/*complications/*drug therapy/virology
EDAT- 2007/05/23 09:00
MHDA- 2007/08/08 09:00
CRDT- 2007/05/23 09:00
PHST- 2007/05/23 09:00 [pubmed]
PHST- 2007/08/08 09:00 [medline]
PHST- 2007/05/23 09:00 [entrez]
AID - 10.1002/jmv.20833 [doi]
PST - ppublish
SO  - J Med Virol. 2007 Jul;79(7):931-4. doi: 10.1002/jmv.20833.