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Human pegivirus‐1 associated leukoencephalitis: Clinical and molecular features
Author(s) -
Balcom Erin F.,
Doan Matthew A.L.,
Branton William G.,
Jovel Juan,
Blevins Gregg,
Edguer Beste,
Hobman Tom C.,
Yacyshyn Elaine,
Emery Derek,
Box Adrian,
van Landeghem Frank K.H.,
Power Christopher
Publication year - 2018
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.25343
Subject(s) - neuropathology , white matter , encephalitis , pathology , gliosis , biology , virology , medicine , immunology , disease , virus , magnetic resonance imaging , radiology
Etiologic diagnosis is uncertain in 35% to 50% of patients with encephalitis, despite its substantial global prevalence and disease burden. We report on 2 adult female patients with fatal leukoencephalitis associated with human pegivirus‐1 (HPgV‐1) brain infection. Neuroimaging showed inflammatory changes in cerebral white matter. Brain‐derived HPgV‐1 RNA sequences clustered phylogenetically with other pegiviruses despite an 87‐nucleotide deletion in the viral nonstructural (NS)2 gene. Neuropathology disclosed lymphocyte infiltration and gliosis predominantly in brain white matter. HPgV‐1 NS5A antigen was detected in lymphocytes as well as in astrocytes and oligodendrocytes. HPgV‐1 neuroadaptation should be considered in the differential diagnosis of progressive leukoencephalitis in humans. Ann Neurol 2018;84:789–795