Large Vessel Arteritis Associated with Human Herpesvirus 6 Infections

Abstract

A 9-month-old boy presented with chronic arteritis of the aorta and its major branches. The clinical manifestations at onset of his illness were compatible with those of Kawasaki syndrome. However, the febrile period lasted for 2 months despite various immunosuppressive therapies, and the levels of C-reactive protein remain high 18 months after onset. Elevated circulating immune complexes, decreased serum complement levels, hypergammaglobulinaemia and monoclonal gammopathy were observed. Active HHV-6 infection was shown by increased serum levels of antihuman herpesvirus-6 (HHV-6) IgG and IgM antibodies, and positive HHV-6 DNA in sera, peripheral blood mononuclear cells (PBMNC) and lymph nodes. HHV-6 was actively replicating in PBMNC and lymph nodes, as shown by the detection of transcripts for the virus structural antigen. These results suggest that large vessel arteritis can be associated with HHV-6 infection.

Human parvovirus B19, varicella zoster virus, and human herpes virus 6 in temporal artery biopsy specimens of patients with giant cell arteritis: analysis with quantitative real time polymerase chain reaction

“…1 Although certain HLA-DR alleles are correlated with GCA, 2 genetic factors are insufficient to explain the marked variation in geographic prevalence 3 and the temporal fluctuation in the incidence of the disease. 1 Different findings suggest that infectious agents may be involved in the pathogenesis of the disease: parvovirus B19 (B19), 4 5 human herpes virus 6 (HHV-6), 6 and varicella zoster virus (VZV). 7 8 This study aimed at determining B19, VZV, and HHV-6 DNA prevalence and viral loads in temporal artery biopsy (TAB) specimens of patients with GCA, to analyse the hypothesis that an environmental factor may have a role in the pathogenesis of GCA.…”

Review Part 3: Human herpesvirus‐6 in multiple non‐neurological diseases

“…HHV‐6 infection of the cardiovascular system in infancy appears to be rare. Two cases of fetal acute myocarditis have been reported in Japan [Fukae et al, 2000; Rohayem et al, 2001; Yoshikawa et al, 2001; Toyabe et al, 2002; Chang et al, 2009]. DNA and serologic studies confirmed that the cause was primary HHV‐6B infection.…”

Dermatological Skin Diseases Associated with Human Herpes Viruses 6, 7 and 8: Review

“…4 HHV-6'nın akut apandisit ve aortta kronik arterite yol açtığına dair yayınlar da bildirilmiştir. 26,27 Ayrıca, HHV-6 reaktivasyonu ile skleroderma arasında güçlü bir ilişki olduğu öne sürülmekte-dir. 28 HHV-6 için tanısal testler seroloji, kültür, immünohistokimya ve nükleik asit incelemelerinden ibarettir.…”