title: A prospective case control study of the association of Gianotti-Crosti syndrome with human herpesvirus 6 and human herpesvirus 7 infections.
abstract: Gianotti-Crosti syndrome (GCS) is known to be associated with hepatitis B and Epstein-Barr virus (EBV) infections. Apart from a single case report based on serology alone, there are no published data on an association between GCS and human herpesvirus 6 (HHV-6) and human herpesvirus 7 (HHV-7) primary infections or reactivations. Our aim was to investigate the association between GCS and HHV-6 and HHV-7 infections. Ten patients diagnosed with GCS at a primary care practice over an 18-month period were recruited. Controls were age- and sex-matched patients with unrelated symptoms requiring venepuncture for other indications. Blood specimens were collected from patients and controls at presentation, and from patients 4 weeks later. Virologic evidence of HHV-6 and HHV-7 infection was sought in peripheral blood leukocytes and plasma using polymerase chain reaction (PCR) for viral DNA, reverse transcriptase polymerase chain reaction (RT-PCR) for HHV-6 U91 mRNA transcripts, and serology. Serology for EBV and hepatitis B virus was done. In contrast to the 10 controls, 2 patients (both infants) with clinically diagnosed GCS had evidence of active HHV-6 infection. This was demonstrated by detection of viral DNA in the absence of antibody in the acute plasma specimens and HHV-6 DNA viral loads of more than 5.3 log10 genome copies/5 microl in the whole blood specimens, a profile previously shown to be diagnostic of recent primary HHV-6 infection. None of the patients had evidence of recent EBV or hepatitis B infection. We conclude that primary HHV-6 infection may be associated with GCS in some infants.
authors.affiliation: Department of Medicine, University of Hong Kong and Queen Mary Hospital, Pokfulam, Hong Kong, SAR. achuh@iohk.com
authors.forename: Antonio An Tung
authors.initials: AA
authors.lastname: Chuh
authors.forename: Henry Hin Lee
authors.initials: HH
authors.lastname: Chan
authors.forename: Susan Shui Seng
authors.initials: SS
authors.lastname: Chiu
authors.forename: Hoi Yee
authors.initials: HY
authors.lastname: Ng
authors.forename: Joseph Sriyal Malik
authors.initials: JS
authors.lastname: Peiris
mesh_terms: D000169:Acrodermatitis / Q000821:virology*; D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005077:Exanthema Subitum / Q000150:complications*; D005260:Female; D015654:Herpesvirus 6, Human / Q000302:isolation & purification*; D016199:Herpesvirus 7, Human / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction; D019349:Roseolovirus Infections / Q000150:complications*; D018709:Statistics, Nonparametric
chemical_list: D004279:DNA, Viral