Clinical manifestations of human herpesvirus 6 (HHV-6) have not been clearly defined, and the role of HHV-6 in human disease among infants and children in Kuwait remains to be fully elucidated. A retrospective study covering the period between 2008 and 2014 was conducted on infants and children aged from 1 month to 5 years. Blood and CSF samples from infants and children who presented with symptoms suggestive HHV-6 infection were subjected to PCR test for HHV-6. Results showed that 9.3% (n = 42) of infants and children were positive for HHV-6. Fever was the most noticeable symptoms, presenting in 50% (n = 21) of the patients. Also, neutropenia was highly associated with HHV-6 infection, where it presented in 35.8% (n = 15) of infants and children. Our results provided important information about the clinical outcome of HHV-6 infection among infants and children in Kuwait.
KeywordsHHV-6PCRKuwait
Al Fawaz, T., Ng, V., Richardson, S.E., Barton, M. and Allen, U. (2014) Clinical Consequences of Human Herpesvirus-6 DNAemia in Peripheral Blood in Pediatric Liver Transplant Recipients. Pediatric Transplantation, 1, 47-51.http://dx.doi.org/10.1111/petr.12176
Abdel-Haq, N.M. and Asmar, B.I. (2004) Human Herpesvirus 6 (HHV6) Infection. Indian Journal of Pediatrics, 71, 89-96. http://dx.doi.org/10.1007/BF02725664
Laina, I., Syriopoulou, V.P., Daikos, G.L., Roma, E.S., et al. (2010) Febrile Seizures and Primary Human Herpesvirus 6 Infection. Pediatric Neurology, 42, 28-31. http://dx.doi.org/10.1016/j.pediatrneurol.2009.07.016
Vianna, R.A., de Oliveira, S.A., Camacho, L.A., Knowles, W., et al. (2008) Role of Human Herpesvirus 6 Infection in Young Brazilian Children with Rash Illnesses. The Pediatric Infectious Disease Journal, 27, 533-537.http://dx.doi.org/10.1097/INF.0b013e3181673c50
Tait, D.R., Ward, K.N., Brown, D.W. and Miller, E. (1996) Measles and Rubella Misdiagnosed in Infants as Exanthem Subitum (Roseola Infantum). BMJ, 312, 101. http://dx.doi.org/10.1136/bmj.312.7023.101
Tremlay C. and Brady, M. (2014) Human Herpesvirus 6 Infection in Children: Clinical Manifestations; Diagnosis; and Treatment. http://www.uptodate.com/contents/human-herpesvirus-6-infection-in-children-clinical-manifestations-diagnosis-and-treatment
Hall, C.B., Long, C.E., Schnabel, K.C., Caserta, M.T., et al. (1994) Human Herpesvirus-6 Infection in Children—A Prospective Study of Complications and Reactivation. The New England Journal of Medicine, 18, 432-438.http://dx.doi.org/10.1056/NEJM199408183310703
Zerr, D.M., Meier, A.S., Selke, S.S., Frenkel, L.M., Huang, M.L., et al. (2005) A Population-Based Study of Primary Human Herpesvirus 6 Infection. The New England Journal of Medicine, 352, 768-776. http://dx.doi.org/10.1056/NEJMoa042207
Irving, W.L., Chang, J., Raymond, D.R., Dunstan, R., Grattan-Smith, P. and Cunningham, A.L. (1990) Roseola Infantum and Other Syndromes Associated with Acute HHV6 Infection. Archives of Disease in Childhood, 65, 1297-300.http://dx.doi.org/10.1136/adc.65.12.1297
Rohayem, J., Dinger, J., Fischer, R., Klingel, K., Kandolf, R. and Rethwilm, A. (2001) Fatal Myocarditis Associated with Acute Parvovirus B19 and Human Herpesvirus 6 Coinfection. Journal of Clinical Microbiology, 39, 4585-4587.http://dx.doi.org/10.1128/JCM.39.12.4585-4587.2001
Bozzola, E., Krzysztofiak, A., Bozzola, M., Calcaterra, V., Quondamcarlo, A., Lancella, L. and Villani, A. (2012) HHV6 Meningoencephalitis Sequelae in Previously Healthy Children. Infection, 40, 563-566. http://dx.doi.org/10.1007/s15010-012-0295-9
Noguchi, T., Yoshiura, T., Hiwatashi, A., Togao, O., Yamashita, K., Nagao, E., et al. (2010) CT and MRI Findings of Human Herpesvirus 6-Associated Encephalopathy: Comparison with Findings of Herpes Simplex Virus Encephalitis. American Journal of Roentgenology, 194, 754-760. http://dx.doi.org/10.2214/AJR.09.2548
Yao, K., Honarmand, S., Espinosa, A., Akhyani, N., Glaser, C. and Jacobson, S. (2009) Detection of Human Herpesvirus-6 in Cerebrospinal Fluid of Patients with Encephalitis. Annals of Neurology, 65, 257-267. http://dx.doi.org/10.1002/ana.21611
Husain, E.H., Mullah-Ali, A., Al-Sharidah, S., Azab, A.F. and Adekile, A. (2012) Infectious Etiologies of Transient Neutropenia in Previously Healthy Children. Pediatric Infectious Disease Journal, 31, 575-577. http://dx.doi.org/10.1097/INF.0b013e318250084a
Gautheret-Dejean, A., Manichanh, C., Thien-Ah-Koon, F., Fillet, A.M., Mangeney, N., Vidaud, M., et al. (2002) Development of a Real-Time Polymerase Chain Reaction Assay for the Diagnosis of Human Herpesvirus-6 Infection and Application to Bone Marrow Transplant Patients. Journal of Virological Methods, 100, 27-35. http://dx.doi.org/10.1016/S0166-0934(01)00390-1
Dalwai, A., Ahmad, S., Pacsa, A. and Al-Nakib, W. (2009) Echovirus Type 9 Is an Important Cause of Viral Encephalitis in Infants and Young Children in Kuwait. Journal of Clinical Virology, 44, 48-51. http://dx.doi.org/10.1016/j.jcv.2008.10.007
Valiaveedan, R., Rao, S., Miller, S. and Brown, A. (1987) Transient Neutropenia of Childhood. Clinical Pediatrics, 26, 639-642. http://dx.doi.org/10.1177/000992288702601204
Freitas, R.B., Monteiro, T.A. and Linhares, A.C. (2000) Outbreaks of Human-Herpes Virus 6 (HHV-6) Infection in Day-Care Centers in Belém, Pará, Brazil. Revista do Instituto de Medicina Tropical de São Paulo, 42, 305. http://dx.doi.org/10.1590/S0036-46652000000600002
Millichap, J.G. and Millichap, J.J. (2006) Role of Viral Infections in the Etiology of Febrile Seizures. Pediatric Neurology, 35, 165-172. http://dx.doi.org/10.1016/j.pediatrneurol.2006.06.004
Asano, Y., Yoshikawa, T., Suga, S., Kobayashi, I., Nakashima, T., et al. (1994) Clinical Features of Infants with Primary Human Herpesvirus 6 Infection (Exanthem Subitum, Roseola Infantum). Pediatrics, 93, 104-108.
Barone, S.R., Kaplan, M.H. and Krilov, L.R. (1995) Human Herpesvirus-6 Infection in Children with First Febrile Seizures. Journal of Pediatrics, 127, 95-97. http://dx.doi.org/10.1016/S0022-3476(95)70263-6
Karavanaki, K., Polychronopoulou, S., Giannaki, M., Haliotis, F., Sider, B., Brisimitzi, M., et al. (2006) Transient and Chronic Neutropenias Detected in Children with Different Viral and Bacterial Infections. Acta Paediatrica, 95, 565-572. http://dx.doi.org/10.1080/08035250500477537
Ansari, A., Li, S., Abzug, M.J. and Weinberg, A. (2004) Human Herpesviruses 6 and 7 and Central Nervous System Infection in Children. Emerging Infectious Diseases, 10, 1450-1454. http://dx.doi.org/10.3201/eid1008.030788
McCullers, J.A., Lakeman, F.D. and Whitley, R.J. (1995) Human Herpesvirus 6 Is Associated with Focal Encephalitis. Clinical Infectious Diseases, 21, 571-576. http://dx.doi.org/10.1093/clinids/21.3.571
Hoshino, A., Saitoh, M., Oka, A., Okumura, A., Kubota, M., Saito, Y., et al. (2012) Epidemiology of Acute Encephalopathy in Japan, with Emphasis on the Association of Viruses and Syndromes. Brain and Development, 34, 337-343. http://dx.doi.org/10.1016/j.braindev.2011.07.012
de Pagter, P.J., Schuurman, R., Visscher, H., de Vos, M., Bierings, M., van Loon, A.M., et al. (2008) Human Herpes Virus 6 Plasma DNA Positivity after Hematopoietic Stem Cell Transplantation in Children: An Important Risk Factor for Clinical Outcome. Biology of Blood and Marrow Transplant, 14, 831-839. http://dx.doi.org/10.1016/j.bbmt.2008.04.016
Pichereau, C., Desseaux, K., Janin, A., Scieux, C., de Latour, R.P., Xhaard, A., et al. (2012) The Complex Relationship between Human Herpesvirus 6 and Acute Graft-versus-Host Disease. Biology of Blood and Marrow Transplant, 18, 141-144. http://dx.doi.org/10.1016/j.bbmt.2011.07.018