Knox K K, Carrigan D R
Department of Pathology, Medical College of Wisconsin, Milwaukee 53226, USA.
J Acquir Immune Defic Syndr Hum Retrovirol. 1995 May 1;9(1):69-73.
White matter disease is a relatively common neuropathological change observed in the central nervous system (CNS) tissues of patients with AIDS at autopsy. This disease ranges from small foci of myelin loss to extensive areas of demyelination. In the studies reported here, four of six unselected adult patients with AIDS had areas of demyelination in their CNS tissues at the time of their deaths. In the tissues examined, the severity of the demyelinative disease varied among the patients from a single focus of demyelination to essentially confluent loss of myelin in subcortical white matter and other CNS structures. The demyelinative disease in the brains of these patients was closely associated with active HHV-6 infection. The infected cells were present only in areas of demyelination, and they were never observed in tissue areas free of pathological changes. The HHV-6-associated neuropathology observed in the brains of these patients was identical to that described in an adult bone marrow transplant (BMT) patient with fatal HHV-6 encephalitis. Thus HHV-6-induced white matter disease appears to be a distinct pathological syndrome. Pathogenic mechanisms involved in this disease are unknown. However, the existence of HHV-6 leukoencephalopathy in a BMT patient demonstrates the potential for HHV-6 leukoencephalopathy in a BMT patient demonstrates the potential for HHV-6 to cause this syndrome without need for a cofactor or copathogen such as HIV.
白质病是在艾滋病患者尸检时中枢神经系统（CNS）组织中观察到的一种相对常见的神经病理学改变。这种疾病范围从髓鞘损失的小病灶到广泛的脱髓鞘区域。在本文报道的研究中，六名未经挑选的成年艾滋病患者中有四名在死亡时其CNS组织存在脱髓鞘区域。在所检查的组织中，脱髓鞘疾病的严重程度在患者之间各不相同，从单个脱髓鞘病灶到皮质下白质和其他CNS结构中基本上融合的髓鞘丧失。这些患者大脑中的脱髓鞘疾病与活跃的HHV-6感染密切相关。被感染的细胞仅存在于脱髓鞘区域，在无病理变化的组织区域从未观察到。在这些患者大脑中观察到的与HHV-6相关的神经病理学与一名患有致命性HHV-6脑炎的成年骨髓移植（BMT）患者中所描述的相同。因此，HHV-6诱导的白质病似乎是一种独特的病理综合征。该疾病涉及的致病机制尚不清楚。然而，一名BMT患者中存在HHV-6白质脑病证明了HHV-6导致这种综合征的可能性，而无需诸如HIV这样的辅助因子或共同病原体。
