Early diagnosis of primary human herpesvirus 6 infection in childhood: serology, polymerase chain reaction, and virus load.
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.
Chiu
S S
SS
Department of Pediatrics and Microbiology, University of Hong Kong.
Cheung
C Y
CY
Tse
C Y
CY
Peiris
M
M
D000914:Antibodies, Viral / Q000032:analysis; D002675:Child, Preschool; D004279:DNA, Viral / Q000032:analysis; D005077:Exanthema Subitum / Q000175:diagnosis* / Q000821:virology; D015654:Herpesvirus 6, Human / Q000235:genetics / Q000302:isolation & purification; D016199:Herpesvirus 7, Human / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007223:Infant; D016133:Polymerase Chain Reaction; D019562:Viral Load
D000914:Antibodies, Viral; D004279:DNA, Viral; D007074:Immunoglobulin G