Human Herpesvirus (HHV) 6

The development of techniques for the culture of lymphoid cells and the isolation of viruses that infect these cells led to the discovery of human herpesvirus (HHV) 6 in 1986. At the time, HHV-6 was the first new human herpesvirus to be discovered in roughly a quarter of a century, and its isolation marked the beginning of an era of discovery in herpesvirology, with the identification of HHV-7 and HHV-8 (Kaposi's sarcoma-associated herpesvirus) during the following decade. Like most human herpesviruses, HHV-6 is ubiquitous and capable of establishing a lifelong, latent infection of its host. HHV-6 is particularly efficient at infecting infants and young children, and primary infection with the virus is associated with roseola infantum (exanthem subitum) and, most commonly, an undifferentiated febrile illness. Viral reactivation in the immunocompromised host has been linked to a variety of diseases, including encephalitis, and HHV-6 has been tentatively associated with multiple sclerosis.

HHV6 and Nexco

We (at Dr. Ablashi's) began with Kutapressin, two cc. daily. Most PWCs are familiar with Kutapressin based on the work done by Drs. Steinbach and Hermann. (Eds. Note: The investigation of the use of Kutapressin in CFIDS by Drs. Hermann and Steinbach was first reported in the February 1988 issue of The CFIDS Chronicle. Please see the articles in the Summer ’93 Chronicle, pg. 72, and the Spring/Summer 1990 issue, pg. 25 for recent summaries of their work.) Kutapressin is a brand name of porcine liver extract and polypeptides originally developed during the late 1940s. It has been used in the past for inflammatory reactions of the skin and also for treatment of herpes zoster infections. The exact mechanism of Kutapressin is not well known; it is felt that perhaps the polypeptides derived from the porcine liver may potentiate lymphokines which may then have an effect on the immune function. It is unknown whether Kutapressin acts by competitively inhibiting lymphokine receptors or whether it reactivates receptors enabling these to reverse the deleterious effects of an upregulated immune system.

Katupressin is an extremely well-tolerated medication with minimal side effects. At our clinic, we have not had any patients who have not tolerated Kutapressin except for one patient who was allergic to pork (this is a contraindication). Kutapressin is given by injection, either intramuscular or subcutaneous. The cost of Kutapressin is somewhat prohibitive; at the time of writing. It is approximately $85 per vial. However, in the state of Michigan, we have had success in having Blue Cross/Blue Shield and several other major insurers cover Kutapressin. Usually, the effects take several weeks to develop and our initial trial lasts for 90 to 120 days. If the patient does not improve, we reevaluate the diagnosis of viral activation and, if we feel the patient is truly virally activated, we increase the dosage to four cc. daily.

Kutapressin is an extremely safe polypeptide that has shown, at least in the test tube, to have activity against HHV-6. Therefore, I believe a clinical trial of Kutapressin is warranted in any patient who is HHV-6 EA positive. (I am unaware of any other medications that have activity against HHV-6, except Ampligen, which is not available.) Once we have Kutapressin on board, we look for ways to improve the patient’s overall immune function.