Pruksananonda P, Hall C B, Insel R A, McIntyre K, Pellett P E, Long C E, Schnabel K C, Pincus P H, Stamey F R, Dambaugh T R
Department of Pediatrics, University of Rochester School of Medicine, N.Y. 14642-8689.
N Engl J Med. 1992 May 28;326(22):1445-50. doi: 10.1056/NEJM199205283262201.
Human herpesvirus 6 (HHV-6) is a recently discovered virus that, on the basis of serologic evidence, appears to infect most children by the age of three years. However, the clinical manifestations of primary HHV-6 infection have not been well defined.
We studied consecutive children two years old or younger who presented to an emergency ward with febrile illnesses. Our evaluation included the isolation of HHV-6 from peripheral-blood mononuclear cells, an immunofluorescent-antibody assay, the detection of HHV-6 by the polymerase chain reaction (PCR), and restriction-endonuclease-fragment profiles of HHV-6 isolates.
HHV-6 was isolated from 34 of 243 acutely ill children (14 percent). The children with viremia had irritability, high temperatures (mean, 39.7 degrees C), and inflammation of tympanic membranes (in 21), but few other localizing signs. Two children were hospitalized, but all 34 recovered after an average of four days of fever. The rash characteristic of roseola, which has been associated with HHV-6 infection, was noted in only three children. In 29 children (85 percent), serum samples obtained during convalescence had at least a fourfold increase in IgG antibody titers; 4 infants less than three months old who presumably had maternal antibody did not have this increase. HHV-6 was isolated from blood obtained during convalescence in only one child, but in two thirds of the children the virus could be detected by PCR. The isolates had genomic heterogeneity, indicating the presence of multiple strains.
Primary infection with HHV-6 is a major cause of acute febrile illness in young children. Such infection is associated with varied clinical manifestations, viremia, and the frequent persistence of the viral genome in mononuclear cells.
人类疱疹病毒6型（HHV - 6）是一种最近发现的病毒，根据血清学证据，似乎在大多数儿童三岁时就已感染。然而，原发性HHV - 6感染的临床表现尚未明确界定。
我们研究了连续就诊于急诊病房的两岁及以下发热疾病患儿。我们的评估包括从外周血单个核细胞中分离HHV - 6、免疫荧光抗体检测、通过聚合酶链反应（PCR）检测HHV - 6以及HHV - 6分离株的限制性内切酶片段图谱分析。
在243名急性病患儿中，34名（14%）分离出HHV - 6。病毒血症患儿表现为易激惹、高热（平均39.7摄氏度）以及鼓膜炎症（21例），但其他定位体征较少。两名患儿住院，但所有34名患儿在平均发热四天后均康复。仅三名患儿出现了与HHV - 6感染相关的玫瑰疹特征性皮疹。29名患儿（85%）在恢复期采集的血清样本中IgG抗体滴度至少增加了四倍；4名小于三个月大的婴儿可能有母体抗体，未出现这种增加。仅一名患儿在恢复期从血液中分离出HHV - 6，但三分之二的患儿可通过PCR检测到该病毒。分离株具有基因组异质性，表明存在多种毒株。
原发性HHV - 6感染是幼儿急性发热疾病的主要原因。这种感染与多种临床表现、病毒血症以及病毒基因组在单核细胞中的频繁持续存在有关。
