Human Herpesvirus 6A (HHV-6A) Encephalitis in an Immunocompetent Patient and Its Association With Glioblastoma: A Case Report

TL;DR

A case report explores HHV-6A encephalitis in an immunocompetent patient who later developed glioblastoma, suggesting a possible link between the virus and tumor formation.

Contribution

This case report highlights a potential association between HHV-6A infection and glioblastoma in an immunocompetent individual.

Findings

HHV-6A meningoencephalitis was diagnosed in an immunocompetent patient followed by glioblastoma within months.

Valganciclovir treatment was used, raising questions about antiviral therapy's role in glioblastoma progression.

The case suggests a possible link between HHV-6A and gliomagenesis, though causation remains unproven.

Abstract

Human herpesvirus 6 (HHV-6) is a neurotropic virus capable of establishing latency in the central nervous system. While its reactivation is well-documented in immunocompromised individuals, its role in immunocompetent hosts remains unclear. Additionally, growing but inconclusive evidence suggests a potential association between HHV-6 and glioblastoma.

We present the case of a 65-year-old immunocompetent male who developed HHV-6A-associated meningoencephalitis, followed by the diagnosis of high-grade glioblastoma within months. The patient initially presented with altered consciousness, seizures, fever, and right-sided motor deficits, leading to a diagnosis of HHV-6A meningoencephalitis confirmed by cerebrospinal fluid and plasma polymerase chain reaction. Despite clinical improvement with antiviral therapy, he developed progressive neurological symptoms two months later, and neuroimaging revealed multiple expansile lesions with significant mass effects. A stereotactic brain biopsy confirmed the diagnosis of glioblastoma, isocitrate dehydrogenase-wildtype, and the patient ultimately succumbed to the disease.

The temporal association between HHV-6A infection and glioblastoma raises critical questions about its potential role in tumorigenesis. While previous studies have detected HHV-6 DNA and proteins in glioma tissues, supporting hypotheses of viral-mediated inflammation, immune modulation, and oncogenic interactions, a direct causal link remains unproven. Additionally, the patient’s treatment with valganciclovir, an antiviral explored as a potential glioblastoma adjuvant therapy, prompts discussion about its possible influence on tumor progression. Further research into HHV-6’s oncogenic potential may provide valuable insights into gliomagenesis and open avenues for novel therapeutic strategies, including antiviral approaches in glioblastoma management.

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