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Article: Laboratory diagnosis of primary Human Herpesvirus-6 (HHV6) and -7 (HHV7) infection on the acute blood sample

TitleLaboratory diagnosis of primary Human Herpesvirus-6 (HHV6) and -7 (HHV7) infection on the acute blood sample
Authors
Issue Date1997
PublisherOxford University Press. The Journal's web site is located at http://www.oxfordjournals.org/our_journals/cid/
Citation
Clinical Infectious Diseases, 1997, v. 25 n. 2, p. 403 How to Cite?
AbstractHuman Herpesvirus (HHV) 6 causes roseola, febrile seizure and acute febrile illnesses in young children. HHV 7 is closely related to HHV6 but its clinical role is less clear. The current methods of documenting primary HHV infection by culture of leukocytes or seroconversion are not rapid enough to have any clinical impact. We hypothesized that demonstration of viral DNA in the blood combined with negative serology indicates a primary infection. IgG antibodies to HHV6 and HHV7 were detected by immunofluorescence. Viral DNA was detected by PCR in whole blood and plasma. Ninety children under 3 years of age admitted to our pediatric unit with fever (T>38.5 rectal) without a clinically apparent bacterial illness were recruited. Acute and convalescent blood samples were obtained in 40 patients. An acute blood sample only was available in 50 patients. The discharge diagnoses were made 'blinded' to the laboratory investigator. Thirty-two patients had an alternative microbiologie diagnosis (eg., Influenza, Parainfluenza, Respiratory Syncytial virus etc). Of the remaining 58 patients, 33 had paired blood samples. We found seroconversion with a fourfold rise of HHV6 IgG in 36 patients, 15 of whom also had a characteristic profile of leukocyte positive for HHV6 DNA with a negative HHV6 IgG in the acute samples. Only 12 were also plasma positive. Eleven of these 16 patients had a diagnosis of Roseola. Seroconversion with a fourfold rise of HHV7 IgG with PCR positive leukocytes and plasma was also seen in 3 of these 16 patients. Of the 25 patients with only an acute blood sample with no alternative diagnosis, 9 had the characteristic profile for primary HHV6 infection, 5 of whom had Roseola. None of the 32 patients with an alternative diagnosis had seroconversion of HHV-6 or -7, nor the characteristic profile in the acute blood sample. The sensitivity and specificity of this profile in the acute blood for diagnosing primary HHV6 infection was 94% and 100% respectively.
Persistent Identifierhttp://hdl.handle.net/10722/170376
ISSN
2015 Impact Factor: 8.736
2015 SCImago Journal Rankings: 4.742

 

DC FieldValueLanguage
dc.contributor.authorChiu, SSen_HK
dc.contributor.authorPeiris, JSMen_HK
dc.date.accessioned2012-10-30T06:07:53Z-
dc.date.available2012-10-30T06:07:53Z-
dc.date.issued1997en_HK
dc.identifier.citationClinical Infectious Diseases, 1997, v. 25 n. 2, p. 403en_HK
dc.identifier.issn1058-4838en_HK
dc.identifier.urihttp://hdl.handle.net/10722/170376-
dc.description.abstractHuman Herpesvirus (HHV) 6 causes roseola, febrile seizure and acute febrile illnesses in young children. HHV 7 is closely related to HHV6 but its clinical role is less clear. The current methods of documenting primary HHV infection by culture of leukocytes or seroconversion are not rapid enough to have any clinical impact. We hypothesized that demonstration of viral DNA in the blood combined with negative serology indicates a primary infection. IgG antibodies to HHV6 and HHV7 were detected by immunofluorescence. Viral DNA was detected by PCR in whole blood and plasma. Ninety children under 3 years of age admitted to our pediatric unit with fever (T>38.5 rectal) without a clinically apparent bacterial illness were recruited. Acute and convalescent blood samples were obtained in 40 patients. An acute blood sample only was available in 50 patients. The discharge diagnoses were made 'blinded' to the laboratory investigator. Thirty-two patients had an alternative microbiologie diagnosis (eg., Influenza, Parainfluenza, Respiratory Syncytial virus etc). Of the remaining 58 patients, 33 had paired blood samples. We found seroconversion with a fourfold rise of HHV6 IgG in 36 patients, 15 of whom also had a characteristic profile of leukocyte positive for HHV6 DNA with a negative HHV6 IgG in the acute samples. Only 12 were also plasma positive. Eleven of these 16 patients had a diagnosis of Roseola. Seroconversion with a fourfold rise of HHV7 IgG with PCR positive leukocytes and plasma was also seen in 3 of these 16 patients. Of the 25 patients with only an acute blood sample with no alternative diagnosis, 9 had the characteristic profile for primary HHV6 infection, 5 of whom had Roseola. None of the 32 patients with an alternative diagnosis had seroconversion of HHV-6 or -7, nor the characteristic profile in the acute blood sample. The sensitivity and specificity of this profile in the acute blood for diagnosing primary HHV6 infection was 94% and 100% respectively.en_HK
dc.languageengen_US
dc.publisherOxford University Press. The Journal's web site is located at http://www.oxfordjournals.org/our_journals/cid/en_HK
dc.relation.ispartofClinical Infectious Diseasesen_HK
dc.titleLaboratory diagnosis of primary Human Herpesvirus-6 (HHV6) and -7 (HHV7) infection on the acute blood sampleen_HK
dc.typeArticleen_HK
dc.identifier.emailChiu, SS: ssschiu@hku.hken_HK
dc.identifier.emailPeiris, JSM: malik@hkucc.hku.hken_HK
dc.identifier.authorityChiu, SS=rp00421en_HK
dc.identifier.authorityPeiris, JSM=rp00410en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.scopuseid_2-s2.0-33748198227en_HK
dc.identifier.volume25en_HK
dc.identifier.issue2en_HK
dc.identifier.spage403en_HK
dc.identifier.epage403en_HK
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridChiu, SS=7202291500en_HK
dc.identifier.scopusauthoridPeiris, JSM=7005486823en_HK

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