Early diagnosis of primary human herpesvirus 6 infection in childhood: serology, polymerase chain reaction, and virus load

J Infect Dis. 1998 Nov;178(5):1250-6. doi: 10.1086/314432.

Abstract

Qualitative and quantitative polymerase chain reaction (PCR) for human herpesvirus 6 (HHV-6) DNA in whole blood and plasma was correlated with serology and clinical assessment in 143 children hospitalized for undifferentiated febrile illness to evaluate options for diagnosis of primary HHV-6 infection on the acute blood specimen. PCR and serology for HHV-7 were done in parallel to define serologic cross-reactions. Using HHV-6 seroconversion as the reference standard, detection of HHV-6 DNA in whole blood in the absence of antibody in the plasma was the most reliable evidence of primary HHV-6 infection. Detection of HHV-6 DNA in plasma and a high virus load in whole blood (>3.3 log10 copies/5 microL) had a sensitivity of 90% and 100%, respectively, in diagnosing primary HHV-6 infection. However, both were occasionally found in patients with other infections, possibly associated with HHV-6 reactivation. Maternal antibody may confound interpretation of serology in patients under 3 months of age.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Viral / analysis
  • Child, Preschool
  • DNA, Viral / analysis
  • Exanthema Subitum / diagnosis*
  • Exanthema Subitum / virology
  • Herpesvirus 6, Human / genetics
  • Herpesvirus 6, Human / isolation & purification
  • Herpesvirus 7, Human / genetics
  • Herpesvirus 7, Human / isolation & purification
  • Humans
  • Immunoglobulin G / analysis
  • Infant
  • Polymerase Chain Reaction
  • Viral Load*

Substances

  • Antibodies, Viral
  • DNA, Viral
  • Immunoglobulin G