Detection of human herpesvirus-6 in cerebrospinal fluid of patients with encephalitis.

Yao, K., Honarmand, S., Espinosa, A., Akhyani, N., Glaser, C., Jacobson, S.
Journal   Ann Neurol.
Analytes Measured  
Matrix Tested   Cerebrospinal fluid (CSF)
Year   2009
Volume   65
Page Numbers   257-267
Application   Immunogenicity

OBJECTIVE: Virus infections are the most common causes of encephalitis, a syndrome characterized by acute inflammation of the brain. More than 150 different viruses have been implicated in the pathogenesis of encephalitis; however, because of limitations with diagnostic testing, causative factors of more than half of the cases remain unknown.

METHODS: To investigate whether human herpesvirus-6 (HHV-6) is a causative agent of encephalitis, we examined for evidence of virus infection by determining the presence of viral sequence using polymerase chain reaction and assessed HHV-6 antibody reactivity in the cerebrospinal fluid of encephalitis patients with unknown cause. In a cohort study, we compared virus-specific antibody levels in cerebrospinal fluid samples of patients with encephalitis, relapsing-remitting multiple sclerosis, and other neurological diseases.

RESULTS: Our results demonstrated increased levels of HHV-6 IgG, as well as IgM levels, in a subset of encephalitis patients compared with other neurological diseases. Moreover, cell-free viral DNA that is indicative of active infection was detected in 40% (14/35) of encephalitis patients, whereas no amplifiable viral sequence was found in either relapsing-remitting MS or other neurological diseases patients. In addition, a significant correlation between polymerase chain reaction detection and anti-HHV-6 antibody response was also demonstrated.

INTERPRETATION: Collectively, these results suggested HHV-6 as a possible pathogen in a subset of encephalitis cases.

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