Per Ljungman is an MD, PhD hematologist who is in charge of one of the largest transplant centers in Europe at the Karolinska Institute gave a talk on HHV-6 CNS infections in transplant patients at the recent ICAAC conference in October 2004. He uses foscarnet and ganciclovir and finds that ganciclovir is only effective 50% of the time. Transplant patients reactivate almost exclusively with the B variant, not the A variant.

Ljungman says HHV-6 is one of the few viruses that cause mental confusion so he immediately tests for it in the spinal fluid when post transplant patients come in with complaints of cognitive problems. He treats any level of HHV-6 DNA positivity in the spinal fluid, even low copies, i.e. 200 copies/ml. He says normals do not have HHV-6 DNA in the spinal fluid, and that this was proven by a study that looked at leukemia patients. (None were positive in the spinal fluid.)

According to Ljungman, radiographic examinations are not always helpful. The CT scan is almost always normal. The MRI is normal in almost half of the cases and the CSF is not particularly characteristic. However DNA is identified in the CSF in all of them.

He summarized results from antiviral treatment of the 30 published Medline reports of HHV-6 encephalitis:

Antiviral drug %survived
Ganciclovir 4/5
Foscarnet 8/10
Acyclovir 0/1
Foscarnet & GCV 3/8
IVIG 0/1

See Experimental & Alternative Treatments
Read more about foscarnet, ganciclovir and cidovofir

See the Foundation’s interview with Drs. Eric De Clerq and Lieve Naessen’s of the Rega Institute on epilepsy and antiviral treatment

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