Association of human herpesvirus 6 infection with exanthem subitum in Belem, Brazil

Freitas, Ronaldo Barros de; Linhares, Alexandre C.; Oliveira, Consuelo Silva de; Gusmão, R. H. P.; Linhares, Maria Ieda Siqueira

doi:10.1590/s0036-46651995000600003

Cited by 7 publications

(4 citation statements)

References 14 publications

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“…Several studies 2,3,5,45 record that active HHV-6A infection occurs later in life when compared with HHV-6B infection. Indeed, the latter variant appears to infect mainly infants younger than 3 years 24,33,58 . It is noticeable, however, that this has not invariably happened among our study subjects.…”

Section: Discussionmentioning

confidence: 99%

Evidence of active herpesvirus 6 (variant-A) infection in patients with lymphadenopathy in Belém, Pará, Brazil

Freitas

Linhares

2003

Rev. Inst. Med. trop. S. Paulo

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SUMMARYA total of 323 patients with lymphadenopathy were selected in Belém, Brazil, between January 1996 and December 2001, and screened for the presence of human herpesvirus-6 (HHV-6) IgM-and-IgG antibodies by enzyme-linked immunosorbent assay (ELISA). When seroprevalence is analyzed by gender, similar rates are found for female (60.6%) and male (55.7%) individuals. Seventy-seven (23.8%) patients were HHV-6-IgM-and-IgG-positive (IgM+ subgroup), with positivity rates of 29.7% and 17.7% (p = 0.0007) for female-and male individuals, respectively. Sera from a subgroup (n = 120) of these subjects, with high HHV-6 antibody levels (either IgM+ or IgG+ reactivities), were subsequently processed for the presence of HHV-6 DNA by polymerase chain reaction (PCR)/nested PCR. Active infections (IgM+ and/or IgG+ high levels specific antibodies plus detection of viral DNA) were diagnosed in 20/77 (20.0%) and 8/43 (18.6%); subgroup of the 120 individuals suspected of having HHV-6 suggestive recent infection. All (n = 28) cases of active infection were found to be associated with HHV-6 variant-A (HHV-6A), as detectable by PCR/nested PCR, using variant-specific primer that amplify regions of 195 base pairs (bp) (HHV-6A) and 423 bp (HHV-6B). Rates of HHV-6 DNA detection between female and male patients were similar (p > 0.05) in the IgM+ and IgG+ groups: 20.4% versus 35.7% and 25.0% versus 13.0%, respectively. HHV-6 DNA was detected across ≤ 5 through 41-50-year age-groups for patients whose serum samples were IgM+, with rates ranging from 7.7% (female subjects aged ≤ 5 years) to 80.0% (male, 11-20 years). Among patients whose serological status was IgG+, HHV-6 DNA was detected in ≤ 5, 6-10, 21-30 and > 50 age-groups at rates that ranged from 15.4% (male, ≤ 5 years of age) to 100.0% (female aged 11-20 years). Swelling cervical lymph nodes were the most common sign, accounting for 9 (32.0%) cases in each gender group. Among patients (n = 28) with active infection by HHV-6A variant, duration of symptoms lasted 1-5 days in 35.7% of subjects, whereas in 64.3% of them the disease lasted 6-20 days. Our data suggest that it is worth seeking for HHV-6 infection whenever a patient (infant or adult) presents with lymphadenopathy as a prominent symptom in the course of an acute febrile illness.

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Section: Discussionmentioning

confidence: 99%

Evidence of active herpesvirus 6 (variant-A) infection in patients with lymphadenopathy in Belém, Pará, Brazil

Freitas

Linhares

2003

Rev. Inst. Med. trop. S. Paulo

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“…Subsequent serosurvey studies conducted in the Amazon region of Brazil yielded prevalence rates of HHV-6 antibody that ranged from 5.4% to 14.9%, among amerindians 16 , and from 75% to 100% in the urban communities 17 . Furthermore, the occurrence of ES in Brazil in association with HHV-6 infection was first reported on both clinical and laboratorial grounds, by FREITAS et al 18 .…”

Section: Introductionmentioning

confidence: 97%

Outbreaks of human-herpes virus 6 (HHV-6) infection in day-care centers in Belém, Pará, Brazil

Freitas

Monteiro

Linhares

2000

Rev. Inst. Med. trop. S. Paulo

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SUMMARYA total of 730 children aged less than 7 years, attending 8 day-care centers (DCCs) in Belém, Brazil were followed-up from January to December 1997 to investigate the occurrence of human-herpes virus 6 (HHV-6) infection in these institutional settings. Between October and December 1997 there have been outbreaks of a febrile-and -exanthematous disease, affecting at least 15-20% of children in each of the DCCs. Both serum-and-plasma samples were obtained from 401 (55%) of the 730 participating children for the detection of HHV-6 antibodies by enzyme-linked immunosorbent assay (ELISA), and viral DNA amplification through the nested-PCR. Recent HHV-6 infection was diagnosed in 63.8% (256/401) of them, as defined by the presence of both IgM and IgGspecific antibodies (IgM+/IgG+); of these, 114 (44.5%) were symptomatic and 142 (55.5%) had no symptoms (p = 0.03). A subgroup of 123 (30.7%) children were found to be IgM-/IgG+, whereas the remaining 22 (5.5%) children had neither IgM nor IgG HHV-6-antibodies (IgM-/IgG-). Of the 118 children reacting strongly IgM-positive (³ 30 PANBIO units), 26 (22.0%) were found to harbour the HHV-6 DNA, as demonstrated by nested-PCR. Taken the ELISA-IgM-and-nested PCR-positive results together, HHV-6 infection was shown to have occurred in 5 of the 8 DCCs under follow-up. Serological evidence of recent infections by Epstein-Barr virus (EBV) and parvovirus B19 were identified in 2.0% (8/401) and 1.5% (6/401) of the children, respectively. Our data provide strong evidence that HHV-6 is a common cause of outbreaks of febrile/exanthematous diseases among children attending DCCs in the Belém area.

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“…68 In addition to the characteristic rash, fever, and occasionally febrile seizures and encephalitis, 69 , 70 children with exanthema subitum can experience lymphadenopathy, relative lymphocytosis with increased CD38+ (immature) T cells, and hepatomegaly. 69 , 71 , 72 …”

Section: Benign/reactive Lymphoproliferative Disordersmentioning

confidence: 99%

Lymphoproliferative Syndromes Associated With Human Herpesvirus-6a and Human Herpesvirus-6b

Eliassen

Krueger

Luppi

et al. 2018

Mediterr J Hematol Infect Dis

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Human herpesvirus 6A and 6B (HHV-6A and HHV-6B) have been noted since their discovery for their T-lymphotropism. Although it has proven difficult to determine the extent to which HHV-6A and HHV-6B are involved in the pathogenesis of many diseases, evidence suggests that primary infection and reactivation of both viruses may induce or contribute to the progression of several lymphoproliferative disorders, ranging from benign to malignant and including infectious mononucleosis-like illness, drug induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms (DIHS/DRESS), and nodular sclerosis Hodgkin’s lymphoma. Herein, we discuss the conditions associated with the lymphoproliferative capacity of HHV-6, as well as the potential mechanisms behind them. Continued exploration on this topic may add to our understanding of the interactions between HHV-6 and the immune system and may open the doors to more accurate diagnosis and treatment of certain lymphoproliferative disorders.

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Association of human herpesvirus 6 infection with exanthem subitum in Belem, Brazil

Cited by 7 publications

References 14 publications

Evidence of active herpesvirus 6 (variant-A) infection in patients with lymphadenopathy in Belém, Pará, Brazil

Evidence of active herpesvirus 6 (variant-A) infection in patients with lymphadenopathy in Belém, Pará, Brazil

Outbreaks of human-herpes virus 6 (HHV-6) infection in day-care centers in Belém, Pará, Brazil

Lymphoproliferative Syndromes Associated With Human Herpesvirus-6a and Human Herpesvirus-6b

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