title: The spectrum of clinical and laboratory findings resulting from human herpesvirus-6 (HHV-6) in patients with mononucleosis-like illnesses not resulting from Epstein-Barr virus or cytomegalovirus.
abstract: Recently, the morphologic, immunologic, and molecular makeup of a new virus designated human herpesvirus-6 (HHV-6) has been described. Because cell cultures of HHV-6-infected mononuclear cells showed prominent lymphocytic changes, it could be anticipated that mononucleosis-like illnesses or lymphoproliferative disorders would turn out to be manifestations of active HHV-6 infection. In the present study, blood samples from 27 patients previously categorized as having non-Epstein-Barr virus (non-EBV)/noncytomegalovirus (non-CMV) heterophil-negative mononucleosis-like illnesses were tested for IgM and IgG antibodies to HHV-6. Eight of these patients (30%) had serologic evidence of active HHV-6 infection. The clinical spectrum includes a short-lived febrile illness, mild cervical lymphadenopathy, laboratory data suggestive of active viral hepatitis in two patients, and a prolonged febrile illness in a single patient with previously documented positive anti-HIV serology. The viral studies revealed the presence of fourfold HHV-6-specific IgG titer increases by immunofluorescent assay (IFA) in seven serially studied cases and positive IgM serology on one or more samples tested by IFA or enzyme-linked immunosorbent assay (ELISA) in all eight cases. The authors could not determine whether the illnesses represented primary HHV-6 infections in susceptible individuals or reactivation of latent virus. HHV-6 serologic studies may be indicated in patients with mononucleosis-like illnesses with atypical lymphocytosis when EBV and CMV test results are nondiagnostic.
authors.affiliation: Department of Internal Medicine, Metropolitan-Mount Sinai Medical Center, Minneapolis, Minnesota 55404.
authors.forename: T A
authors.initials: TA
authors.lastname: Steeper
authors.forename: C A
authors.initials: CA
authors.lastname: Horwitz
authors.forename: D V
authors.initials: DV
authors.lastname: Ablashi
authors.forename: S Z
authors.initials: SZ
authors.lastname: Salahuddin
authors.forename: C
authors.initials: C
authors.lastname: Saxinger
authors.forename: R
authors.initials: R
authors.lastname: Saltzman
authors.forename: B
authors.initials: B
authors.lastname: Schwartz
mesh_terms: D000293:Adolescent; D000328:Adult; D000888:Antibodies, Anti-Idiotypic / Q000032:analysis; D000914:Antibodies, Viral / Q000032:analysis*; D002648:Child; D002675:Child, Preschool; D003587:Cytomegalovirus / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006566:Herpesviridae Infections / Q000097:blood / Q000276:immunology*; D004854:Herpesvirus 4, Human / Q000276:immunology; D015654:Herpesvirus 6, Human / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D007244:Infectious Mononucleosis / Q000276:immunology*; D008297:Male
chemical_list: D000888:Antibodies, Anti-Idiotypic; D000914:Antibodies, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M