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

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


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.