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Open Forum Infect Dis. 2019 Nov 5;6(11):ofz465. doi: 10.1093/ofid/ofz465. eCollection 2019 Nov.

Trillions and Trillions: Herpes Simplex Virus-1 Hepatitis in an Immunocompetent Adult.

Author information

1
Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA.
2
Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA.
3
Immunopathogenesis Section, National Institute of Allergy and Infectious Disease, Bethesda, Maryland, USA.
4
Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, Washington, USA.
5
Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington, Seattle, Washington, USA.
6
Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, Washington, USA.
7
Clinical Research Division, Fred Hutchinson Cancer Research Center Seattle, Washington, USA.
8
Department of Global Health, University of Washington, Seattle, Washington, USA.
9
Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
10
Benaroya Research Institute, Seattle, Washington, USA.

Abstract

We describe a case of acute liver failure and myopericarditis due to herpes simplex virus-1 (HSV-1) in an immunocompetent adult. We estimate that, at the height of viremia, the patient contained a quantity of HSV-1 virions approaching that of human cells. The patient recovered with acyclovir that was dose-adjusted for neurotoxicity and developed a vigorous anti-HSV-1 T-cell response.

KEYWORDS:

HSV hepatitis; HSV-1; hepatitis; herpes simplex virus; host response; viral evolution

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