title: Prospective Characterization of the Risk Factors for Transmission and Symptoms of Primary Human Herpesvirus Infections Among Ugandan Infants.
abstract: BACKGROUND
  Human herpesvirus (HHV) infections are common during infancy. Primary infections are frequently asymptomatic and best studied prospectively by using direct viral detection.
  
  
  METHODS
  Oropharyngeal swab specimens were collected weekly from Ugandan newborn infants, their mothers, and other children in the household. Blood specimens were collected every 4 months. Samples were tested for herpes simplex virus (HSV) types 1 and 2, Epstein-Barr virus (EBV), cytomegalovirus (CMV), HHV-6A, HHV-6B, and HHV-8, using quantitative polymerase chain reaction.
  
  
  RESULTS
  Thirty-two infants, 32 mothers, and 49 other household children were followed for a median of 57 weeks. Seventeen mothers had human immunodeficiency virus type 1 (HIV) infection; no infants acquired HIV-1. The 12-month incidence of postnatal infection was 76% for HHV-6B, 59% for CMV, 47% for EBV, 8% for HSV-1, and 0% for HHV-8. The quantity of oropharyngeal shedding by contacts was associated with HHV-6A or HHV-6B transmission. Maternal HIV-1 infection was associated with EBV transmission, while breastfeeding and younger child contacts were associated with CMV transmission. Except for HSV-1, primary HHV infections were subclinical.
  
  
  CONCLUSIONS
  By capturing exposures and acquisition events, we found that the incidence and risk factors of infection vary by HHV type. HSV-1 infection, unlike other HHV infections, caused acute clinical illness in these infants.
authors.affiliation: University of British Columbia, Child and Family Research Institute, Vancouver, Canada Fred Hutchinson Cancer Research Center.
authors.forename: Soren
authors.initials: S
authors.lastname: Gantt
authors.affiliation: Uganda Cancer Institute, Kampala.
authors.forename: Jackson
authors.initials: J
authors.lastname: Orem
authors.affiliation: Fred Hutchinson Cancer Research Center.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Krantz
authors.affiliation: Fred Hutchinson Cancer Research Center University of Washington, Seattle.
authors.forename: Rhoda Ashley
authors.initials: RA
authors.lastname: Morrow
authors.affiliation: University of Washington, Seattle.
authors.forename: Stacy
authors.initials: S
authors.lastname: Selke
authors.affiliation: Fred Hutchinson Cancer Research Center University of Washington, Seattle.
authors.forename: Meei-Li
authors.initials: ML
authors.lastname: Huang
authors.affiliation: Fred Hutchinson Cancer Research Center University of Washington, Seattle.
authors.forename: Joshua T
authors.initials: JT
authors.lastname: Schiffer
authors.affiliation: Fred Hutchinson Cancer Research Center University of Washington, Seattle.
authors.forename: Keith R
authors.initials: KR
authors.lastname: Jerome
authors.affiliation: Uganda Cancer Institute, Kampala.
authors.forename: Annet
authors.initials: A
authors.lastname: Nakaganda
authors.affiliation: Fred Hutchinson Cancer Research Center University of Washington, Seattle.
authors.forename: Anna
authors.initials: A
authors.lastname: Wald
authors.affiliation: Fred Hutchinson Cancer Research Center University of Washington, Seattle.
authors.forename: Corey
authors.initials: C
authors.lastname: Casper
authors.affiliation: Fred Hutchinson Cancer Research Center University of Washington, Seattle.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Corey
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006564:Herpesviridae / Q000302:isolation & purification*; D006566:Herpesviridae Infections / Q000097:blood* / Q000453:epidemiology / Q000503:physiopathology / Q000635:transmission*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D014454:Uganda / Q000453:epidemiology
keywords: Epstein-Barr virus; HHV-6A; HHV-6B; HHV-8; HIV-exposed uninfected; cytomegalovirus; herpes simplex virus; infant; primary infection