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[人疱疹病毒6型脑炎]

[Human herpesvirus 6 encephalitis].

作者信息

Yoshikawa Tetsushi

机构信息

Department of Pediatrics, Fujita Health University School of Medicine, Kutsukaka-cho, Toyoake, Aichi, Japan.

出版信息

Brain Nerve. 2010 Aug;62(8):869-75.

Abstract

Primary human herpesvirus 6 (HHV-6) infection causes exanthem subitum,a common febrile illness,in infants. At the time of primary infection with HHV-6, the virus rarely causes encephalitis. Recently, various types of clinical features of patients with HHV-6 encephalitis have been reported. Therefore, appropriate procedures for the management of these patients should be established on the basis of the clinical features of the patients. In addition to primary infection with the virus, reactivation of HHV-6 can be associated with encephalitis in the case of immunocompromised patients. Numerous copies of the viral DNA were detected in the cerebrospinal fluid collected from the patients. This finding suggests that active viral replication possibly occurred in the brain tissues of these patients. A typical clinical feature of post transplant HHV-6 encephalitis, was the development of amnesia; further, abnormal magnetic resonance imaging (MRI) findings in the hippocampal regions were observed. Thus, HHV-6 is considered to be one of the causative agents for limbic encephalitis that develops in immunocompromised patients. On the basis of the results of in vitro analysis, it has been suggested that ganciclovir and foscarnet have antiviral effects against HHV-6. Although a double-blind control study has not been performed to elucidate the effectiveness of these 2 drugs in vivo, either of the 2 antiviral drugs should be used for the treatment of patients with HHV-6 encephalitis.

摘要

人原发性疱疹病毒6型(HHV-6)感染可导致婴幼儿常见的发热性疾病——幼儿急疹。在原发性HHV-6感染时,该病毒很少引起脑炎。最近,已有关于HHV-6脑炎患者各种临床特征的报道。因此,应根据患者的临床特征制定针对这些患者的适当管理程序。除了病毒的原发性感染外,在免疫功能低下的患者中,HHV-6的重新激活也可能与脑炎有关。在从患者采集的脑脊液中检测到大量病毒DNA拷贝。这一发现表明这些患者的脑组织中可能发生了活跃的病毒复制。移植后HHV-6脑炎的一个典型临床特征是失忆;此外,在海马区观察到异常的磁共振成像(MRI)表现。因此,HHV-6被认为是免疫功能低下患者发生边缘性脑炎的病原体之一。根据体外分析结果,已表明更昔洛韦和膦甲酸钠对HHV-6具有抗病毒作用。虽然尚未进行双盲对照研究以阐明这两种药物在体内的有效性,但这两种抗病毒药物中的任何一种都应用于治疗HHV-6脑炎患者。

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