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Human herpesvirus-6 infections in infants admitted to hospital
M Portolani1, C Cermelli, A Moroni
1Institute of Hygiene, University of Modena, Italy.
Insights
Human herpesvirus-6 (HHV-6) was a common cause of febrile illness in young children, often presenting without a rash. This study identified HHV-6 in over 39% of viral infections, with both primary infections and reactivations occurring.
Area of Science:
- Pediatric infectious diseases
- Virology
- Molecular biology
Background:
- Febrile syndrome in young children can be caused by various viral pathogens.
- Human herpesvirus-6 (HHV-6) is a known cause of exanthem subitum (roseola infantum) and can also be associated with other febrile illnesses.
Purpose of the Study:
- To investigate the spectrum of viral infections in children with febrile syndrome.
- To specifically determine the role of human herpesvirus-6 (HHV-6) in these infections, including primary infections and reactivations.
Main Methods:
- Virological testing was performed on 3-36 month old patients with febrile syndrome.
- Tests included assays for HHV-6, Epstein-Barr virus (EBV), cytomegalovirus (CMV), herpes simplex virus 1 (HSV-1), adenoviruses, parainfluenza viruses, respiratory syncytial virus (RSV), and influenza viruses.
- HHV-6 isolates were analyzed using Southern blot hybridization.
Main Results:
- Viral infections were confirmed in 60.7% of patients.
- HHV-6 was the most frequently identified virus, accounting for 39.6% of infections.
- HHV-6 infections included 72% primary infections and 28% reactivations. Of those with primary HHV-6 infection, 40% presented with exanthem subitum, while 60% had febrile syndrome without rash.
Conclusions:
- HHV-6 is a significant cause of febrile illness in young children, frequently occurring without a rash.
- Both primary HHV-6 infections and reactivations contribute to febrile syndromes in this age group.
- Circulating HHV-6 strains identified in this study showed similarities among themselves but differed from the reference strain U1102.
Abstract:
Virological studies were carried out on 3 to 36-month-old patients admitted to the Children's Hospital of the University of Modena with febrile syndrome from September 1990 to February 1991. Virological tests were carried out for human herpesvirus-6 (HHV-6), Epstein-Barr virus (EBV), cytomegalovirus (CMV), herpes simplex virus 1 (HSV-1), adenoviruses, parainfluenza viruses 1, 2 and 3, respiratory syncytial virus (RSV) and influenza viruses A and B. Viral infections were confirmed in 60.7% patients: 39.6% were correlated with HHV-6, 5.4% with EBV, 5.4% with both HHV-6 and EBV, 5.4% with adenoviruses, 1.8% with HSV-1, 1.8% with CMV and 1.8% with an unidentified herpes-like lymphotropic virus. HHV-6 isolates were obtained from either peripheral blood lymphocytes (PBLs) or pharyngeal secretion of the infected children. HHV-6 infections included both primary infections (72%) and reactivations (28%). Among HHV-6 infected children, 40%, with exanthem subitum, had infections presenting serological evidence of primary infection and virus isolation from PBLs. The remaining cases of primary infection and the cases of reactivation were found in patients with febrile syndrome without rash (60%). HHV-6 isolates were obtained either from PBLs or pharyngeal secretions from these patients. Southern blot hybridization of the DNAs of 4 HHV-6 isolates showed that the circulating HHV-6 strains all appeared similar, but differed from the HHV-6 strain U1102 used as a positive control.