First therapeutic use of Artesunate in treatment of human herpesvirus 6B myocarditis in a child

J Clin Virol. 2013 Jun;57(2):157-60. doi: 10.1016/j.jcv.2013.02.005. Epub 2013 Mar 6.

Abstract

Background: Human herpesvirus 6 (HHV-6) is an important cause of fulminant or acute viral myocarditis. However, insufficiency of standard antiviral treatment against HHV-6 is an emerging problem.

Objectives: To describe the case of child with HHV-6 myocarditis who was treated by unloading with a left ventricular assist device and Artesunate.

Study design: Case report supported by histological and viral diagnoses via a combination of histology/immunohistochemistry and polymerase chain reaction techniques performed on cardiac tissues before and after treatment.

Results: Following therapeutic intervention, the clinical status and heart function improved. Endomyocardial biopsies revealed decreased levels of HHV-6B DNA in the myocardium and the disappearance of histological findings in support of lymphocytic myocarditis. Left ventricular assist device could be explanted. No adverse effects of Artesunate were noted.

Conclusions: In addition to existing heart failure treatments, Artesunate can be considered as an effective candidate for clinical use in cases of HHV-6B associated myocarditis.

Publication types

  • Case Reports

MeSH terms

  • Antiviral Agents / pharmacology
  • Antiviral Agents / therapeutic use*
  • Artemisinins / pharmacology
  • Artemisinins / therapeutic use*
  • Artesunate
  • Heart-Assist Devices
  • Herpesvirus 6, Human / drug effects*
  • Herpesvirus 6, Human / genetics
  • Humans
  • Infant
  • Myocarditis / drug therapy*
  • Myocarditis / virology
  • Polymerase Chain Reaction
  • Roseolovirus Infections / drug therapy*
  • Roseolovirus Infections / virology
  • Treatment Outcome
  • Ventricular Dysfunction, Left / pathology
  • Ventricular Dysfunction, Left / therapy

Substances

  • Antiviral Agents
  • Artemisinins
  • Artesunate