title: Human herpesvirus-6 infection: a prospective study evaluating HHV-6 DNA levels in liver from children with acute liver failure.
abstract: The aim of this prospective study was to investigate the role of HHV-6 infection in children with acute onset of liver failure using real-time quantitative PCR. Twenty-three children (median age, 24 months) were included: 6 cases of fulminant hepatic failure of undetermined cause (group 1); 4 cases of fulminant hepatic failure of recognized cause (group 2); 3 cases of acute decompensation of chronic liver disease (group 3); and 10 cases of chronic liver disease (group 4). HHV-6 genomic DNA was detected and quantified using real-time PCR in plasma and livers obtained at the time of transplantation. HHV6-DNA detection rate was significantly higher among groups 1, 2, and 3 compared to group 4 (76.9% vs. 20% P = 0.02). Viral loads ranged from 6 to 32,500 copies/106 cells. Significantly higher viral loads were found in 4 of 9 children with acute onset of liver failure of unknown origin (group 1, n = 3; group 3, n = 1) and 1 child with fulminant autoimmune hepatitis (group 2) (P = 0.03). These results strongly support the hypothesis that HHV-6 may cause fulminant hepatic failure and acute decompensation of chronic liver disease in children. Nevertheless, a threshold viral load value still remains to be determined.
authors.affiliation: Pediatric Intensive Care Unit, Bicêtre Hospital, AP-HP, Le Kremlin Bicêtre, France. laurent.chevret@bct.aphp.fr
authors.forename: Laurent
authors.initials: L
authors.lastname: Chevret
authors.forename: David
authors.initials: D
authors.lastname: Boutolleau
authors.forename: Nadia
authors.initials: N
authors.lastname: Halimi-Idri
authors.forename: Sophie
authors.initials: S
authors.lastname: Branchereau
authors.forename: Catherine
authors.initials: C
authors.lastname: Baujard
authors.forename: Monique
authors.initials: M
authors.lastname: Fabre
authors.forename: Agnès
authors.initials: A
authors.lastname: Gautheret-Dejean
authors.forename: Dominique
authors.initials: D
authors.lastname: Debray
mesh_terms: D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000032:analysis* / Q000097:blood; D005260:Female; D015654:Herpesvirus 6, Human / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D007963:Leukocytes, Mononuclear / Q000821:virology; D008099:Liver / Q000821:virology*; D017114:Liver Failure, Acute / Q000150:complications* / Q000821:virology*; D016031:Liver Transplantation; D008297:Male; D011446:Prospective Studies; D019349:Roseolovirus Infections / Q000150:complications* / Q000821:virology*
chemical_list: D004279:DNA, Viral