Journal Article

Persistence of Human Herpesvirus 6 According to Site and Variant: Possible Greater Neurotropism of Variant A

Caroline Breese Hall, Mary T. Caserta, Kenneth C. Schnabel, Christine Long, Leon G. Epstein, Richard A. Insel and Stephen Dewhurst

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 26, issue 1, pages 132-137
Published in print January 1998 | ISSN: 1058-4838
Published online January 1998 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/516280
Persistence of Human Herpesvirus 6 According to Site and Variant: Possible Greater Neurotropism of Variant A

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Little is known of the persistence and pathogenicity of human herpesvirus 6 (HHV-6) after primary infection, including the role of strain variant. Over 2 to 5 years, 2,716 children and 149 families were studied. Peripheral blood mononuclear cell (PBMC), saliva, and cerebrospinal fluid (CSF) specimens were examined for HHV-6 DNA and variant. Ninety-nine percent of isolates causing primary infection were HHV-6 variant B (HHV-6B), which predominated in 95%–98% of the variants persisting in PBMC and saliva specimens from children and adults. Of 668 CSF samples, 13% contained HHV-6 DNA; of 77 children examined after primary infection, 61% had HHV-6 DNA detected only in their CSF and 39% had HHV-6 DNA in both CSF and PBMCs. HHV-6 variant A (HHV-6A) was detected significantly (P = .0001) more frequently in CSF than in PBMCs or saliva. In children for whom HHV-6 was identified in both CSF and PBMCs, PBMCs contained only HHV-6B, while CSF contained HHV-6A or HHV-6B, not both. Thus, in patients with dual infection, only HHV-6A persisted in CSF, which suggests that HHV-6A has greater neurotropism. Findings for adults indicate that dual infection occurs; variant persistence is similar to that for children. The frequency of HHV-6A infection increased little with age, thereby indicating that HHV- 6A infection remains uncommon into adulthood. This study suggests that HHV-6 variants have different immunobiologic courses and neurotropism.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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