Herpes simplex type 2 encephalitis and methotrexate medication: a fortuitous or causative association in a patient with spondyloarthritis?

Julien Lupo (1, 2) , Ophélie dos Santos (3) , Raphaële Germi (1, 2) , Monique Baccard-Longère (4) , Jean-Paul Stahl (5) , Olivier Epaulard (6) , Patrice Morand (2)

1 UGA UFRP - Université Grenoble Alpes - UFR Pharmacie
2 IBS - UMR 5075 - Institut de biologie structurale
3 UGA UFRM - Université Grenoble Alpes - UFR Médecine
4 Laboratoire de virologie
5 Service de maladies infectieuses et tropicales
6 Department of infectious diseases

It is unclear whether immunosuppression is a risk factor for herpes encephalitis. Herein, we describe a rare case of herpes simplex virus type 2 encephalitis in a patient treated with low-dose methotrexate for HLA-B27-associated spondyloarthritis. The patient was successfully treated with acyclovir but presented sequelae of encephalitis. Here we discuss the possible role of low-dose methotrexate therapy as a risk factor of neurological herpes reactivation and severe disease. The host-related and viral risk factors are also addressed.

Domaines: Biologie structurale [q-bio.BM]

Julien Lupo, Ophélie dos Santos, Raphaële Germi, Monique Baccard-Longère, Jean-Paul Stahl, et al.. Herpes simplex type 2 encephalitis and methotrexate medication: a fortuitous or causative association in a patient with spondyloarthritis?. Antiviral Therapy, 2017, 22 (4), pp.357-359. ⟨10.3851/IMP3110⟩. ⟨hal-02059962⟩