Severe hepatitis with autoimmune features following a HHV-6: a case report

HHV-6 has been identified as the aetiologic agent of exanthem subitum in infants and an acute febrile illness in young children. HHV-6 probably remains latent in the body after the primary infection and it reactivates upon host immunosuppression in a manner similar to other human herpes viruses. Primary HHV-6 infection in adults is very rare and it is not clear whether disease manifestations are similar to those observed in children.We report the case of acute hepatitis in a 18-year-old immunocompetent woman presenting with sever jaundice and liver dysfunction. Serum immunoglobulin levels were elevated (3.8 gr/dl) with a titre of anti nucleus antibody of 1:640. Serological data demonstrated the presence of IgM antibodies against human herpesvirus-6 in the serum and of viral DNA on liver biopsy by real time quantitative polymerase chain reaction, with a viral load of 280 genomes/106 of cellular genomes. No other etiologic agents were found to induce hepatitis and the patient was diagnosed as having HHV-6 triggered autoimmune acute hepatitis.