The Story behind The Lady Upstairs

Sunday, June 23, 2013

Detection and typing of human herpes virus 6 by molecular methods, in specimens from patients diagnosed with encephalitis/meningitis


Norma P. Tavakoli*, Seela Nattanmai, Rene Hull, Heather Fusco, Lela Dzigua, Heng Wang, and Michelle Dupuis
Wadsworth Center, New York State Department of Health, Albany NY, and School of Public Health, SUNY Albany, Albany, NY

ABSTRACT

Human herpesvirus-6 (HHV-6) was detected in specimens from patients hospitalized with symptoms of encephalitis or meningitis. A real-time PCR assay was developed which has a linear dynamic range of 5 to 5 x 106 copies of HHV-6 and a sensitivity of 5 gene copies per reaction. While the assay detects both subtypes HHV-6A and HHV-6B, it is specific and does not cross-react with a selected specificity panel. A total of 1,482 patient specimens, which were collected between 2003 and 2007, were tested; 26 specimens from 24 patients were found to be positive by real-time PCR for HHV-6. The HHV-6 detection rate in this population was therefore 1.75%. The majority of the specimens tested (>95%) were cerebrospinal fluid (CSF) specimens. We were able to type 20 of the 26 positive specimens by conventional PCR and sequence analysis; all were HHV-6B. 42% of the patients were ≤3 years of age, which may indicate a primary infection in these patients. Given the ages of the remaining patients (from 4 to 81), their infections were most probably due to virus reactivation. Where information was available, symptoms of patients included fever (71%), altered mental status (67%), and, abnormal CSF profile (75%). 50% of patients ≤3 years of age suffered from seizures. The detection of HHV-6 in specimens from patients diagnosed with encephalitis or meningitis, in the absence of a positive PCR result for other agents, strongly suggests a role for HHV-6 in pathogenesis of these central nervous system diseases J. Clin. Microbiol. doi:10.1128/JCM.01692-07

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