title: Selective reactivation of human herpesvirus 6 variant a occurs in critically ill immunocompetent hosts.
abstract: Reactivation of human beta-herpesviruses (cytomegalovirus [CMV], human herpesvirus [HHV]-6, and HHV-7) in nonimmunocompromised hosts is rare. Because these viruses are susceptible to reactivation by cytokines and stress-related mechanisms, the incidence of their reactivation was investigated among 120 patients during stress related to critical illness and compared with findings among 50 healthy volunteers. Human beta-herpesvirus DNA was found in 65% of critically ill patients (60% men; mean age, 63 years) who required admission to an intensive care unit for medical (40%) or surgical (53%) indications or trauma (7%). HHV-6 reactivation was higher in critically ill patients than in healthy volunteers (54/101 vs. 0/50; P=.001). All patients except 1 were confirmed as HHV-6 variant A (mean virus load, 5066 copies/10(6) peripheral blood leukocytes). The reactivation of HHV-6A did not affect disease severity and outcome. No significant reactivation of HHV-7 or CMV was demonstrated among the critically ill patients. These findings contribute to the less-defined epidemiology of HHV-6A infection.
authors.affiliation: Division of Infectious Diseases and Internal Medicine, Mayo Clinic and Foundation, Rochester, MN 55905, USA.
authors.forename: Raymund R
authors.initials: RR
authors.lastname: Razonable
authors.forename: Cara
authors.initials: C
authors.lastname: Fanning
authors.forename: Robert A
authors.initials: RA
authors.lastname: Brown
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Espy
authors.forename: Antonio
authors.initials: A
authors.lastname: Rivero
authors.forename: Jennie
authors.initials: J
authors.lastname: Wilson
authors.forename: Walter
authors.initials: W
authors.lastname: Kremers
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Smith
authors.forename: Carlos V
authors.initials: CV
authors.lastname: Paya
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018141:Betaherpesvirinae / Q000235:genetics / Q000254:growth & development; D002318:Cardiovascular Diseases / Q000150:complications; D003141:Communicable Diseases / Q000150:complications; D016638:Critical Illness; D004279:DNA, Viral / Q000097:blood; D005260:Female; D014644:Genetic Variation; D015654:Herpesvirus 6, Human / Q000235:genetics* / Q000254:growth & development*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000150:complications; D019349:Roseolovirus Infections / Q000150:complications* / Q000235:genetics / Q000276:immunology*; D014775:Virus Activation / Q000276:immunology*; D014947:Wounds and Injuries / Q000150:complications
chemical_list: D004279:DNA, Viral