Hepatitis Due to Human Herpesvirus-6

Dubedat, Sally; Kappagoda, Nalini K.

doi:10.1016/s0140-6736(89)92077-1

Cited by 72 publications

(24 citation statements)

References 5 publications

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“…Since virtually all children become infected early life, primary HHV-6 infections among adults are rare events. Whenever these latter conditions occur, however, clinical findings such as lymphadenopathy 38,44,53 , heterophilenegative mononucleosis 3,45 and hepatitis 21 are likely to result. In most of the primary infections by HHV-6 the clinical symptoms are high fever and a rough skin rash, that is, the typical exanthema subitum; convulsions may also be present in those more severe cases.…”

Section: Introductionmentioning

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: Introductionmentioning

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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“…In contrast, about 70% of primoinfections among infants in the USA and Europe are characterized by a mild febrile illness that courses with or without exanthem 42,43 . A variety of other clinical conditions have also been associated with HHV-6 infections namely mononucleosis-like syndrome, sarcoidosis, hepatitis and febrile convulsion 1,5,14,25,27,28,34 .…”

Section: Introductionmentioning

confidence: 99%

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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“…Yamanishi et al (21) reported that HHV-6 is a causative agent of exanthem subitum, and HHV-6 has since been shown to be associated with a spectrum of diseases, including febrile convulsions (9), encephalopathy (7), and liver disease. HHV-6 infection has also been associated with acute liver injury and fulminant hepatitis (2,5,15,18). Recently we have used an in situ hybridization method to show that hepatocytes primarily infected with HHV-6 in the liver of a patient with chronic hepatitis were associated with persistent HHV-6 infection (19).…”

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confidence: 99%

Frequent Detection of the Human Herpesvirus 6-Specific Genomes in the Livers of Children with Various Liver Diseases

et al. 2001

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This study was performed to investigate the frequency of human herpesvirus 6 (HHV-6) infection of the liver in children with a variety of liver diseases and to evaluate the role of HHV-6 infection in pediatric patients with prolonged non-B non-C hepatitis. Detection of the HHV-6 genomes in liver, in peripheral blood mononuclear cells (PBMC), and in plasma was performed by PCR or by in situ hybridization. Liver biopsy materials from 48 patients, in whom HHV-6 infection was serologically confirmed, were available for PCR analysis. Sequences of the HHV-6B genome were detectable in the livers of 36 of 48 patients (75%). The presence of the genome was not associated with serum transaminase activities. The genome was detectable in PBMC of 22 of 31 (71%) patients tested. In these 31 patients HHV-6 was detected in both the livers and PBMC of 20, was detected in PBMC but not in the livers of 2, was detected in the livers but not in PBMC of 3, and was detected in neither of samples of 6. In situ hybridization of the livers of six patients showed the presence of the HHV-6B genome in the nuclei of hepatocytes. The anti-HHV-6 immunoglobulin M antibody was detectable in 2 of 9 of the non-B non-C hepatitis patients, whereas none of the 22 patients with etiology-defined liver diseases tested positive. Cell-free viral DNA was not detectable in either group of patients. Our results showed that HHV-6B is frequently present in the livers of children with a variety of liver diseases but do not support the assumption that HHV-6B infection of the liver is associated with prolonged non-B non-C hepatitis.

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Hepatitis Due to Human Herpesvirus-6

Cited by 72 publications

References 5 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

Frequent Detection of the Human Herpesvirus 6-Specific Genomes in the Livers of Children with Various Liver Diseases

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