PMID- 33587722
OWN - NLM
STAT- MEDLINE
DCOM- 20211028
LR  - 20211028
IS  - 2332-7812 (Electronic)
IS  - 2332-7812 (Linking)
VI  - 8
IP  - 2
DP  - 2021 Mar
TI  - Human Herpesvirus 6 Encephalitis in Immunocompetent and Immunocompromised Hosts.
LID - 10.1212/NXI.0000000000000942 [doi]
LID - e942
AB  - OBJECTIVE: The aim of this study was to analyze the clinical, radiologic, and 
      biological features associated with human herpesvirus 6 (HHV-6) encephalitis in 
      immunocompetent and immunocompromised hosts to establish which clinical settings 
      should prompt HHV-6 testing. METHODS: We performed a retrospective research in 
      the virology database of Fondazione IRCCS Policlinico San Matteo (Pavia, Italy) 
      for all patients who tested positive for HHV-6 DNA in the CSF and/or in blood 
      from January 2008 to September 2018 and separately assessed the number of 
      patients meeting the criteria for HHV-6 encephalitis in the group of 
      immunocompetent and immunocompromised hosts. RESULTS: Of the 926 patients tested 
      for HHV-6 during the period of interest, 45 met the study criteria. Among 
      immunocompetent hosts (n = 17), HHV-6 encephalitis was diagnosed to 4 infants or 
      children presenting with seizures or mild encephalopathy during primary HHV-6 
      infection (CSF/blood replication ratio <<1 in all cases). Among immunocompromised 
      hosts (n = 28), HHV-6 encephalitis was diagnosed to 7 adolescents/adults with 
      hematologic conditions presenting with altered mental status (7/7), seizures 
      (3/7), vigilance impairment (3/7), behavioral changes (2/7), hyponatremia (2/7), 
      and anterograde amnesia (1/7). Initial brain MRI was altered only in 2 patients, 
      but 6 of the 7 had a CSF/blood replication ratio >1. CONCLUSIONS: The detection 
      of a CSF/blood replication ratio >1 represented a specific feature of 
      immunocompromised patients with HHV-6 encephalitis and could be of special help 
      to establish a diagnosis of HHV-6 encephalitis in hematopoietic stem cell 
      transplant recipients lacking radiologic evidence of limbic involvement.
CI  - Copyright (c) 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on 
      behalf of the American Academy of Neurology.
FAU - Berzero, Giulia
AU  - Berzero G
AD  - From the Neuroncology Unit (G.B., E.V., E.M.), and Neuroradiology Unit (M.P., 
      A.P.), IRCCS Mondino Foundation, Pavia; Molecular Virology Unit (G.C., F.B.), 
      Microbiology and Virology Department, Diagnostic Radiology, Interventional 
      Radiology and Neuroradiology Unit (A.M.S.), Bone Marrow Transplantation Unit 
      (A.A.C., P.B., O.B.), Infectious and Tropical Diseases Unit (A.D.M.), Pediatric 
      Clinic (V.R., T.F., S.S.), and Pediatric Hematology/Oncology (F.C., M.Z.), 
      Fondazione IRCCS Policlinico San Matteo, Pavia; and Department of Brain and 
      Behavioral Sciences (A.P.), Department of Molecular Medicine (P.B., O.B.), and 
      Department of Clinical, Surgical, Diagnostic and Paediatric Sciences (F.B.), 
      University of Pavia, Italy.
FAU - Campanini, Giulia
AU  - Campanini G
AD  - From the Neuroncology Unit (G.B., E.V., E.M.), and Neuroradiology Unit (M.P., 
      A.P.), IRCCS Mondino Foundation, Pavia; Molecular Virology Unit (G.C., F.B.), 
      Microbiology and Virology Department, Diagnostic Radiology, Interventional 
      Radiology and Neuroradiology Unit (A.M.S.), Bone Marrow Transplantation Unit 
      (A.A.C., P.B., O.B.), Infectious and Tropical Diseases Unit (A.D.M.), Pediatric 
      Clinic (V.R., T.F., S.S.), and Pediatric Hematology/Oncology (F.C., M.Z.), 
      Fondazione IRCCS Policlinico San Matteo, Pavia; and Department of Brain and 
      Behavioral Sciences (A.P.), Department of Molecular Medicine (P.B., O.B.), and 
      Department of Clinical, Surgical, Diagnostic and Paediatric Sciences (F.B.), 
      University of Pavia, Italy.
FAU - Vegezzi, Elisa
AU  - Vegezzi E
AD  - From the Neuroncology Unit (G.B., E.V., E.M.), and Neuroradiology Unit (M.P., 
      A.P.), IRCCS Mondino Foundation, Pavia; Molecular Virology Unit (G.C., F.B.), 
      Microbiology and Virology Department, Diagnostic Radiology, Interventional 
      Radiology and Neuroradiology Unit (A.M.S.), Bone Marrow Transplantation Unit 
      (A.A.C., P.B., O.B.), Infectious and Tropical Diseases Unit (A.D.M.), Pediatric 
      Clinic (V.R., T.F., S.S.), and Pediatric Hematology/Oncology (F.C., M.Z.), 
      Fondazione IRCCS Policlinico San Matteo, Pavia; and Department of Brain and 
      Behavioral Sciences (A.P.), Department of Molecular Medicine (P.B., O.B.), and 
      Department of Clinical, Surgical, Diagnostic and Paediatric Sciences (F.B.), 
      University of Pavia, Italy.
FAU - Paoletti, Matteo
AU  - Paoletti M
AD  - From the Neuroncology Unit (G.B., E.V., E.M.), and Neuroradiology Unit (M.P., 
      A.P.), IRCCS Mondino Foundation, Pavia; Molecular Virology Unit (G.C., F.B.), 
      Microbiology and Virology Department, Diagnostic Radiology, Interventional 
      Radiology and Neuroradiology Unit (A.M.S.), Bone Marrow Transplantation Unit 
      (A.A.C., P.B., O.B.), Infectious and Tropical Diseases Unit (A.D.M.), Pediatric 
      Clinic (V.R., T.F., S.S.), and Pediatric Hematology/Oncology (F.C., M.Z.), 
      Fondazione IRCCS Policlinico San Matteo, Pavia; and Department of Brain and 
      Behavioral Sciences (A.P.), Department of Molecular Medicine (P.B., O.B.), and 
      Department of Clinical, Surgical, Diagnostic and Paediatric Sciences (F.B.), 
      University of Pavia, Italy.
FAU - Pichiecchio, Anna
AU  - Pichiecchio A
AD  - From the Neuroncology Unit (G.B., E.V., E.M.), and Neuroradiology Unit (M.P., 
      A.P.), IRCCS Mondino Foundation, Pavia; Molecular Virology Unit (G.C., F.B.), 
      Microbiology and Virology Department, Diagnostic Radiology, Interventional 
      Radiology and Neuroradiology Unit (A.M.S.), Bone Marrow Transplantation Unit 
      (A.A.C., P.B., O.B.), Infectious and Tropical Diseases Unit (A.D.M.), Pediatric 
      Clinic (V.R., T.F., S.S.), and Pediatric Hematology/Oncology (F.C., M.Z.), 
      Fondazione IRCCS Policlinico San Matteo, Pavia; and Department of Brain and 
      Behavioral Sciences (A.P.), Department of Molecular Medicine (P.B., O.B.), and 
      Department of Clinical, Surgical, Diagnostic and Paediatric Sciences (F.B.), 
      University of Pavia, Italy.
FAU - Simoncelli, Anna Maria
AU  - Simoncelli AM
AD  - From the Neuroncology Unit (G.B., E.V., E.M.), and Neuroradiology Unit (M.P., 
      A.P.), IRCCS Mondino Foundation, Pavia; Molecular Virology Unit (G.C., F.B.), 
      Microbiology and Virology Department, Diagnostic Radiology, Interventional 
      Radiology and Neuroradiology Unit (A.M.S.), Bone Marrow Transplantation Unit 
      (A.A.C., P.B., O.B.), Infectious and Tropical Diseases Unit (A.D.M.), Pediatric 
      Clinic (V.R., T.F., S.S.), and Pediatric Hematology/Oncology (F.C., M.Z.), 
      Fondazione IRCCS Policlinico San Matteo, Pavia; and Department of Brain and 
      Behavioral Sciences (A.P.), Department of Molecular Medicine (P.B., O.B.), and 
      Department of Clinical, Surgical, Diagnostic and Paediatric Sciences (F.B.), 
      University of Pavia, Italy.
FAU - Colombo, Anna Amelia
AU  - Colombo AA
AD  - From the Neuroncology Unit (G.B., E.V., E.M.), and Neuroradiology Unit (M.P., 
      A.P.), IRCCS Mondino Foundation, Pavia; Molecular Virology Unit (G.C., F.B.), 
      Microbiology and Virology Department, Diagnostic Radiology, Interventional 
      Radiology and Neuroradiology Unit (A.M.S.), Bone Marrow Transplantation Unit 
      (A.A.C., P.B., O.B.), Infectious and Tropical Diseases Unit (A.D.M.), Pediatric 
      Clinic (V.R., T.F., S.S.), and Pediatric Hematology/Oncology (F.C., M.Z.), 
      Fondazione IRCCS Policlinico San Matteo, Pavia; and Department of Brain and 
      Behavioral Sciences (A.P.), Department of Molecular Medicine (P.B., O.B.), and 
      Department of Clinical, Surgical, Diagnostic and Paediatric Sciences (F.B.), 
      University of Pavia, Italy.
FAU - Bernasconi, Paolo
AU  - Bernasconi P
AD  - From the Neuroncology Unit (G.B., E.V., E.M.), and Neuroradiology Unit (M.P., 
      A.P.), IRCCS Mondino Foundation, Pavia; Molecular Virology Unit (G.C., F.B.), 
      Microbiology and Virology Department, Diagnostic Radiology, Interventional 
      Radiology and Neuroradiology Unit (A.M.S.), Bone Marrow Transplantation Unit 
      (A.A.C., P.B., O.B.), Infectious and Tropical Diseases Unit (A.D.M.), Pediatric 
      Clinic (V.R., T.F., S.S.), and Pediatric Hematology/Oncology (F.C., M.Z.), 
      Fondazione IRCCS Policlinico San Matteo, Pavia; and Department of Brain and 
      Behavioral Sciences (A.P.), Department of Molecular Medicine (P.B., O.B.), and 
      Department of Clinical, Surgical, Diagnostic and Paediatric Sciences (F.B.), 
      University of Pavia, Italy.
FAU - Borsani, Oscar
AU  - Borsani O
AUID- ORCID: 0000-0001-7805-7806
AD  - From the Neuroncology Unit (G.B., E.V., E.M.), and Neuroradiology Unit (M.P., 
      A.P.), IRCCS Mondino Foundation, Pavia; Molecular Virology Unit (G.C., F.B.), 
      Microbiology and Virology Department, Diagnostic Radiology, Interventional 
      Radiology and Neuroradiology Unit (A.M.S.), Bone Marrow Transplantation Unit 
      (A.A.C., P.B., O.B.), Infectious and Tropical Diseases Unit (A.D.M.), Pediatric 
      Clinic (V.R., T.F., S.S.), and Pediatric Hematology/Oncology (F.C., M.Z.), 
      Fondazione IRCCS Policlinico San Matteo, Pavia; and Department of Brain and 
      Behavioral Sciences (A.P.), Department of Molecular Medicine (P.B., O.B.), and 
      Department of Clinical, Surgical, Diagnostic and Paediatric Sciences (F.B.), 
      University of Pavia, Italy.
FAU - Di Matteo, Angela
AU  - Di Matteo A
AD  - From the Neuroncology Unit (G.B., E.V., E.M.), and Neuroradiology Unit (M.P., 
      A.P.), IRCCS Mondino Foundation, Pavia; Molecular Virology Unit (G.C., F.B.), 
      Microbiology and Virology Department, Diagnostic Radiology, Interventional 
      Radiology and Neuroradiology Unit (A.M.S.), Bone Marrow Transplantation Unit 
      (A.A.C., P.B., O.B.), Infectious and Tropical Diseases Unit (A.D.M.), Pediatric 
      Clinic (V.R., T.F., S.S.), and Pediatric Hematology/Oncology (F.C., M.Z.), 
      Fondazione IRCCS Policlinico San Matteo, Pavia; and Department of Brain and 
      Behavioral Sciences (A.P.), Department of Molecular Medicine (P.B., O.B.), and 
      Department of Clinical, Surgical, Diagnostic and Paediatric Sciences (F.B.), 
      University of Pavia, Italy.
FAU - Rossi, Virginia
AU  - Rossi V
AUID- ORCID: 0000-0001-8363-9210
AD  - From the Neuroncology Unit (G.B., E.V., E.M.), and Neuroradiology Unit (M.P., 
      A.P.), IRCCS Mondino Foundation, Pavia; Molecular Virology Unit (G.C., F.B.), 
      Microbiology and Virology Department, Diagnostic Radiology, Interventional 
      Radiology and Neuroradiology Unit (A.M.S.), Bone Marrow Transplantation Unit 
      (A.A.C., P.B., O.B.), Infectious and Tropical Diseases Unit (A.D.M.), Pediatric 
      Clinic (V.R., T.F., S.S.), and Pediatric Hematology/Oncology (F.C., M.Z.), 
      Fondazione IRCCS Policlinico San Matteo, Pavia; and Department of Brain and 
      Behavioral Sciences (A.P.), Department of Molecular Medicine (P.B., O.B.), and 
      Department of Clinical, Surgical, Diagnostic and Paediatric Sciences (F.B.), 
      University of Pavia, Italy.
FAU - Foiadelli, Thomas
AU  - Foiadelli T
AUID- ORCID: 0000-0003-0961-428X
AD  - From the Neuroncology Unit (G.B., E.V., E.M.), and Neuroradiology Unit (M.P., 
      A.P.), IRCCS Mondino Foundation, Pavia; Molecular Virology Unit (G.C., F.B.), 
      Microbiology and Virology Department, Diagnostic Radiology, Interventional 
      Radiology and Neuroradiology Unit (A.M.S.), Bone Marrow Transplantation Unit 
      (A.A.C., P.B., O.B.), Infectious and Tropical Diseases Unit (A.D.M.), Pediatric 
      Clinic (V.R., T.F., S.S.), and Pediatric Hematology/Oncology (F.C., M.Z.), 
      Fondazione IRCCS Policlinico San Matteo, Pavia; and Department of Brain and 
      Behavioral Sciences (A.P.), Department of Molecular Medicine (P.B., O.B.), and 
      Department of Clinical, Surgical, Diagnostic and Paediatric Sciences (F.B.), 
      University of Pavia, Italy.
FAU - Savasta, Salvatore
AU  - Savasta S
AD  - From the Neuroncology Unit (G.B., E.V., E.M.), and Neuroradiology Unit (M.P., 
      A.P.), IRCCS Mondino Foundation, Pavia; Molecular Virology Unit (G.C., F.B.), 
      Microbiology and Virology Department, Diagnostic Radiology, Interventional 
      Radiology and Neuroradiology Unit (A.M.S.), Bone Marrow Transplantation Unit 
      (A.A.C., P.B., O.B.), Infectious and Tropical Diseases Unit (A.D.M.), Pediatric 
      Clinic (V.R., T.F., S.S.), and Pediatric Hematology/Oncology (F.C., M.Z.), 
      Fondazione IRCCS Policlinico San Matteo, Pavia; and Department of Brain and 
      Behavioral Sciences (A.P.), Department of Molecular Medicine (P.B., O.B.), and 
      Department of Clinical, Surgical, Diagnostic and Paediatric Sciences (F.B.), 
      University of Pavia, Italy.
FAU - Compagno, Francesca
AU  - Compagno F
AD  - From the Neuroncology Unit (G.B., E.V., E.M.), and Neuroradiology Unit (M.P., 
      A.P.), IRCCS Mondino Foundation, Pavia; Molecular Virology Unit (G.C., F.B.), 
      Microbiology and Virology Department, Diagnostic Radiology, Interventional 
      Radiology and Neuroradiology Unit (A.M.S.), Bone Marrow Transplantation Unit 
      (A.A.C., P.B., O.B.), Infectious and Tropical Diseases Unit (A.D.M.), Pediatric 
      Clinic (V.R., T.F., S.S.), and Pediatric Hematology/Oncology (F.C., M.Z.), 
      Fondazione IRCCS Policlinico San Matteo, Pavia; and Department of Brain and 
      Behavioral Sciences (A.P.), Department of Molecular Medicine (P.B., O.B.), and 
      Department of Clinical, Surgical, Diagnostic and Paediatric Sciences (F.B.), 
      University of Pavia, Italy.
FAU - Zecca, Marco
AU  - Zecca M
AD  - From the Neuroncology Unit (G.B., E.V., E.M.), and Neuroradiology Unit (M.P., 
      A.P.), IRCCS Mondino Foundation, Pavia; Molecular Virology Unit (G.C., F.B.), 
      Microbiology and Virology Department, Diagnostic Radiology, Interventional 
      Radiology and Neuroradiology Unit (A.M.S.), Bone Marrow Transplantation Unit 
      (A.A.C., P.B., O.B.), Infectious and Tropical Diseases Unit (A.D.M.), Pediatric 
      Clinic (V.R., T.F., S.S.), and Pediatric Hematology/Oncology (F.C., M.Z.), 
      Fondazione IRCCS Policlinico San Matteo, Pavia; and Department of Brain and 
      Behavioral Sciences (A.P.), Department of Molecular Medicine (P.B., O.B.), and 
      Department of Clinical, Surgical, Diagnostic and Paediatric Sciences (F.B.), 
      University of Pavia, Italy.
FAU - Baldanti, Fausto
AU  - Baldanti F
AD  - From the Neuroncology Unit (G.B., E.V., E.M.), and Neuroradiology Unit (M.P., 
      A.P.), IRCCS Mondino Foundation, Pavia; Molecular Virology Unit (G.C., F.B.), 
      Microbiology and Virology Department, Diagnostic Radiology, Interventional 
      Radiology and Neuroradiology Unit (A.M.S.), Bone Marrow Transplantation Unit 
      (A.A.C., P.B., O.B.), Infectious and Tropical Diseases Unit (A.D.M.), Pediatric 
      Clinic (V.R., T.F., S.S.), and Pediatric Hematology/Oncology (F.C., M.Z.), 
      Fondazione IRCCS Policlinico San Matteo, Pavia; and Department of Brain and 
      Behavioral Sciences (A.P.), Department of Molecular Medicine (P.B., O.B.), and 
      Department of Clinical, Surgical, Diagnostic and Paediatric Sciences (F.B.), 
      University of Pavia, Italy.
FAU - Marchioni, Enrico
AU  - Marchioni E
AD  - From the Neuroncology Unit (G.B., E.V., E.M.), and Neuroradiology Unit (M.P., 
      A.P.), IRCCS Mondino Foundation, Pavia; Molecular Virology Unit (G.C., F.B.), 
      Microbiology and Virology Department, Diagnostic Radiology, Interventional 
      Radiology and Neuroradiology Unit (A.M.S.), Bone Marrow Transplantation Unit 
      (A.A.C., P.B., O.B.), Infectious and Tropical Diseases Unit (A.D.M.), Pediatric 
      Clinic (V.R., T.F., S.S.), and Pediatric Hematology/Oncology (F.C., M.Z.), 
      Fondazione IRCCS Policlinico San Matteo, Pavia; and Department of Brain and 
      Behavioral Sciences (A.P.), Department of Molecular Medicine (P.B., O.B.), and 
      Department of Clinical, Surgical, Diagnostic and Paediatric Sciences (F.B.), 
      University of Pavia, Italy. enrico.marchioni@mondino.it.
LA  - eng
PT  - Journal Article
DEP - 20210112
PL  - United States
TA  - Neurol Neuroimmunol Neuroinflamm
JT  - Neurology(R) neuroimmunology & neuroinflammation
JID - 101636388
RN  - 0 (Antiviral Agents)
RN  - Human Herpesvirus 6 encephalitis
SB  - IM
CIN - Neurol Neuroimmunol Neuroinflamm. 96:e948.
MH  - Adolescent
MH  - Adult
MH  - Antiviral Agents/cerebrospinal fluid/pharmacology
MH  - Encephalitis, Viral/*cerebrospinal fluid/immunology/*virology
MH  - Female
MH  - *Hematopoietic Stem Cell Transplantation/methods
MH  - Herpesvirus 6, Human/genetics/immunology/*pathogenicity
MH  - Humans
MH  - Immunocompromised Host/immunology
MH  - Male
MH  - Retrospective Studies
MH  - Roseolovirus Infections/*cerebrospinal fluid/immunology/*virology
MH  - Seizures/immunology/therapy/virology
MH  - Young Adult
PMC - PMC7963435
EDAT- 2021/02/16 06:00
MHDA- 2021/10/29 06:00
PMCR- 2021/01/12
CRDT- 2021/02/15 17:07
PHST- 2020/06/13 00:00 [received]
PHST- 2020/11/02 00:00 [accepted]
PHST- 2021/02/15 17:07 [entrez]
PHST- 2021/02/16 06:00 [pubmed]
PHST- 2021/10/29 06:00 [medline]
PHST- 2021/01/12 00:00 [pmc-release]
AID - 8/2/e942 [pii]
AID - NEURIMMINFL2020031930 [pii]
AID - 10.1212/NXI.0000000000000942 [doi]
PST - epublish
SO  - Neurol Neuroimmunol Neuroinflamm. 2021 Jan 12;8(2):e942. doi: 
      10.1212/NXI.0000000000000942. Print 2021 Mar.