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Oral brincidofovir cut the rate of high level HHV-6 viremia by 80%, suggesting that IV brincidofovir may have potential to prevent HHV-6 encephalitis.

In Encephalitis & Encephalopathy, For Clinicians by Kristin Loomis

An abstract at the Transplantation & Cellular Therapy Meeting in Houston showed that only 2% of 92 patients treated with oral brincidofovir developed high level reactivation compared to 11% of 61 patients taking the placebo. The results came from an analysis of stored samples from their previous Phase III SUPPRESS trial for CMV prophylaxis. Chimerix’s Phase III trial for cytomegalovirus failed. Although oral brincidofovir reduced CMV viremia during the first 14 weeks, CMV infections bounced back during the 10-week observation period that followed, and there was a higher mortality rate in the drug group. Analysts blamed the higher death rate on the inability of participating physicians to differentiate between bleeding (a side effect of the drug) and acute GVHD. Instead …

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HHV-6 and EBV found in the brain tissue of Rasmussen’s Encephalitis patients

In All, Autoimmune Disease, CNS Disease, Encephalitis & Encephalopathy by Kristin Loomis

Chinese investigators found a high prevalence of HHV-6 and Epstein Barr virus in the brain tissues of children with Rasmussen’s encephalitis but in none of the controls. There was a significant association between viral presence and brain atrophy, raising a strong suspicion for the involvement of both viruses.

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Foscarnet prophylaxis reduces severity but does not prevent HHV-6 encephalitis

In All, Encephalitis & Encephalopathy, Transplant Complications, Treatments - Antiviral by Kristin Loomis

A Japanese trial of foscarnet prophylaxis in cord blood transplant patients was successful in reducing severity and mortality as well as suppressing high viral loads, but it failed to prevent encephalitis. The authors note that the blood brain barrier must be inflamed to allow effective penetration of the drug into the central nervous system and speculate that the prophylaxis may have protected the meninges.

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HHV-6 induced amnesia after rituximab therapy for autoimmune disease

In All, CNS Dysfunction, Encephalitis & Encephalopathy, Transplant Complications by Kristin Loomis

A young woman on rituximab and two other immunomodulatory agents for the treatment of dermatomyositis developed encephalitis with severe anterograde amnesia. As the use of biologic treatments for refractory autoimmune disease has been increasing, physicians are advised to consider HHV-6 and offer prompt antiviral therapy to limit irreversible morbidity.

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Rapid point-of-care system screens for 14 encephalitis pathogens in one hour!

In All, CNS Disease, CNS Dysfunction, Encephalitis & Encephalopathy by Kristin Loomis

A new point-of-care assay from bioMérieux can simultaneously and rapidly detect 14 pathogens typically found in encephalitis. The machine is designed to be at the clinic or in the emergency room and can be operated by unskilled technicians. In a study of 1,560 immunocompetent patient samples, a total of 1.35% were positive for HHV-6, or about twice the expected rate of 0.8% found with the inherited chromosomally integrated HHV-6.

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GAD antibodies & HHV-6 limbic encephalitis – a case of molecular mimicry?

In All, Autoimmune Disease, CNS Disease, CNS Dysfunction, Encephalitis & Encephalopathy, Epilepsy and Seizures, Latest Scientific News by Kristin Loomis

A fifth case of limbic encephalitis associated with GAD antibodies and HHV-6 infection has been reported, this time in an immunocompetent woman with chromosomally integrated HHV-6, epilepsy, and psychosis. The patient’s condition improved (with a drop in GAD antibody titers and stabilization of psychotic symptoms) in response to three weeks of antiviral therapy but relapsed when antiviral therapy was withdrawn.