Human pegivirus identified in severe myelitis and optic neuritis in immunocompromised patients: A pathogenic role for a forgotten virus?

N Valyraki
E Maillart
V Pourcher
N Shor
S Tran
M Boudot de la Motte
C Houillier
F Domont
E Morvan
M Touat
M Del Mar Amador
J Aboab
B Mathon
A Hesters
C Vignal-Clermont
C Dehais
S Bonnin
F Lafitte
N Villain
S Varnous
O Gout
M Eloit
C Rodriguez
R Deschamps

Source: Rev Neurol (Paris)

Publié le 1 avril 2023

Résumé

The role of Human pegivirus (HPgV) in patients with encephalitis has been recently questioned. We present cases of 4 patients with similar clinical, biological, and radiological characteristics, including a past history of transplantation with long-term immunosuppression and a progressive course of severe and predominantly myelitis, associated in 3 cases with optic neuropathy causing blindness. Extensive workup was negative but analysis of the CSF by use of pan-microorganism DNA- and RNA-based shotgun metagenomics was positive for HPgV. This case series further supports the hypothesis of HPgV CNS infection and highlights the utility of metagenomic next-generation sequencing of CSF in immunocompromised patients.