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Human Herpesvirus 6 Infection

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Human Herpesvirus 6 Infection
Background: The importance of human herpesvirus 6 (HHV-6) as a pathogen in febrile infants ≤90 days of age is unknown.
Objective: To determine whether febrile infants 90 days of age and younger evaluated for sepsis have evidence of HHV-6 DNA in plasma or cerebrospinal fluid (CSF).
Methods: Febrile infants ≤90 days of age were tested for HHV-6 DNA using a real time quantitative fluorescent probe polymerase chain reaction assay.
Results: Eighty samples from 47 infants were tested for HHV-6 DNA; 5 of 47 infants (10.6%) had HHV-6 DNA in plasma. In 2 of the 5 infants with HHV-6 DNA in plasma, HHV-6 DNA was also detected in the CSF. Both infants with evidence of HHV-6 DNA in plasma and CSF had HHV-6 Variant A infection. The quantity of HHV-6 DNA detected ranged from 70 to 169 000 DNA copies/ml. One infant with HHV-6 variant B infection had concomitant Escherichia coli bacteremia and urinary tract infection.
Conclusions: Approximately 10% of febrile infants ≤90 days of age evaluated for sepsis had evidence of HHV-6 infection. HHV-6 Variant A and B infections were seen in these young infants. HHV-6 DNA was found in infants with and without another explanation for fever. Quantification of viral DNA may be important in determining the relevance of HHV-6 DNA in clinical specimens.

Primary infection with human herpesvirus 6 (HHV-6) is an important cause of fever in older infants and toddlers. HHV-6 infections have been described in infants younger than 90 days of age; however, the importance of HHV-6 as a cause of fever in infants younger than 3 months of age is unknown.

Recently PCR testing has become available for HHV-6 DNA. The identification of HHV-6 DNA in cell-free plasma appears to be relatively short lived and has been shown to correlate with primary infection with HHV-6 or active infection in immunocompromised patients. With the availability of rapid testing for HHV-6 DNA by PCR, we undertook a study to document the occurrence of HHV-6 infection in febrile infants 1 to 90 days of age and to describe the clinical findings in HHV-6-positive infants.

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