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A fatal case of Human Herpesvirus 6 chronic myocarditis

kaffiend

Senior Member
Messages
167
Location
California
This case study is in press in the Journal of Clinical Virology. The virus was not found in the heart on biopsy; only post-mortem on autopsy.

A fatal case of Human Herpesvirus 6 chronic myocarditis in an immunocompetent adult
Nicolas Leveque a,? , Camille Boulagnon b , Camille Brasselet c , Franc ? ois Lesaffre c , David Boutolleau d , Damien Metzc, Paul Fornesb, Laurent Andreolettia
a Clinical and Molecular Virology Unit, University Hospital and EA-4303 Faculty of Medicine, Reims, France
b Pathology Department, University Hospital, Reims, France
c Cardiology Department, University Hospital, Reims, France
d Virology Department, Piti-Salptrire University Hospital, AP-HP and UPMC Univ Paris 06, ER1 DETIV, Paris, France

Background: Human Herpesvirus 6 (HHV-6) is an important cause of fulminant or acute viral myocarditis in immunocompromised or immunocompetent patients. However the physiopathological mechanisms of HHV-6 related acute myocarditis and the involvement of subsequent HHV-6 reactivation phases in the development of chronic cardiomyopathies remain to be assessed.
Objectives: To describe a case of fatal HHV-6 chronic myocarditis in an immunocompetent adult.
Study design: Case report and detailed histological and viral diagnoses by combination of histol- ogy/immunohistochemistry and polymerase chain reaction techniques on cardiac tissues.
Results: Histopathological analysis of ventricular tissues showed large interstitial and scarring fibrotic areas with a moderate mononuclear cell infiltrate compatible with histological aspect of chronic myocarditis. Detection of both HHV-6 by real-time PCR and viral glycoproteins in mononuclear and endothelial cells by immunohistochemistry evidenced an ongoing cardiac HHV-6 replication with viral late protein synthesis activity.
Conclusions: This case report indicates that HHV-6 can establish a chronic active myocarditis leading to heart failure in immunocompetent subjects.
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