Clinical features and virological findings in children with primary human herpesvirus 7 infection
Clinical features and virological findings in children with primary human herpesvirus 7 infection
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DOI：
10.1542/peds.99.3.e4
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发表时间：
1997-03-01
期刊：
影响因子：
8
通讯作者：
Asano, Y
中科院分区：
文献类型：
--
作者：
Suga, S;Yoshikawa, T;Asano, Y
目标。目的：探讨原发性人疱疹病毒7 （HHV-7）感染患者的临床特点及HHV-7与人疱疹病毒6 （HHV-6）的血清学和病毒学差异。材料与方法。在19个月的观察期内，对71例伴有或不伴有皮疹的急性发热性呼吸道疾病的婴幼儿（男35例，女36例，平均年龄14.5个月[范围1 ~ 48个月]）进行临床和病毒学检查。采用肝素化血样分离HHV-6和HHV-7，并采用巢式聚合酶链反应扩增法检测两种病毒的DNA序列。用间接免疫荧光法测定两种病毒的抗体活性。15例（男孩6例，女孩9例，平均年龄12.9月龄[范围，7 ~ 27月龄]）感染HHV-7, 10例上呼吸道感染1例，50例发热性惊厥14例（28%），而50例中22例（44%）感染HHV-6。所有15例患者均出现发热（37.5℃），平均最高体温为38.7℃（37.6℃至39.8℃），持续2.9天（1 ~ 5天）。15例患者中有14例（93%）出现丘疹、黄斑或丘疹，于发热第2.9天（范围，第2 ~ 5天）出现在面部、躯干和四肢，持续2.7天（范围，1 ~ 5天）。1例患者发热第一天出现持续数分钟的惊厥发作。13例（87%）患者出现HHV-6抗体，其中8例（53%）患者在初次感染HHV-7时抗体滴度同时显著升高。HHV-7和HHV-6 DNA在急性期和恢复期的单核细胞（MNCs）中几乎总是检测到，而在疾病急性期获得的一些血浆样本中，HHV-7 DNA呈阳性。原发性HHV-7感染的发生时间稍晚于HHV-6，从血液和/或血清中分离出HHV-7转化为该病毒证实了这一点。1例经病毒学证实的原发性HHV-7感染患者的临床特征与原发性HHV-6感染患者具有可比性。在一半的原发性HHV-7感染患者中，先前存在的HHV-6抗体显著增加。急性期外周血MNCs和血浆中检测到HHV-7 DNA，此后在MNCs中持续存在。
Objective. To elucidate clinical features of patients with primary human herpesvirus 7 (HHV-7) infection and serologic and virologic findings between HHV-7 and human herpesvirus 6 (HHV-6).Materials and Methods. During a 19-month observation period, 71 infants and children (35 boys and 36 girls with a mean age of 14.5 months [range, 1 month to 48 months]) who had acute febrile respiratory illness with or without skin rash were examined clinically and virologically. Heparinized blood samples were used for isolation of HHV-6 and HHV-7 and detection of both virus DNA sequences by a nested polymerase chain reaction amplification. Both virus antibody activities were measured by an indirect immunofluorescent assay.Results. HHV-7 infection was observed in 15 (6 boys and 9 girls with a mean age of 12.9 months [range, 7 months to 27 months]), 1 of 10 with upper respiratory infection and 14 (28%) of 50 with febrile exanthem, whereas HHV-6 infection was in 22 (44%) of the 50. Fever (37.5 degrees C) was observed in all 15, with an average maximum body temperature of 38.7 degrees C (range, 37.6 degrees C to 39.8 degrees C), which persisted for 2.9 days (range, 1 to 5 days). Papular, macular, or maculopapular rash was observed in 14 (93%) of the 15, which appeared on day 2.9 of fever (range, days 2 to 5) on the face, trunk, and extremities and persisted for 2.7 days (range, 1 to 5 days). A convulsive seizure that persisted for a few minutes developed in 1 patient on the first day of elevation of fever. HHV-6 antibody was demonstrated in 13 (87%), and a simultaneous significant increase to HHV-6 antibody titers was observed in 8 (53%) of the 15 during primary HHV-7 infection. HHV-7 and HHV-6 DNAs were almost always detected in mononuclear cells (MNCs) during acute and convalescent phases, whereas HHV-7 DNA was positive in some plasma samples obtained during the acute phase of the disease.Conclusions. Primary HHV-7 infection occurred somewhat later than HHV-6, which was confirmed by the isolation of HHV-7 from blood and/or seroconversion to the virus. Clinical features of a virologically confirmed patient with primary HHV-7 infection were comparable with those of primary HHV-6 infection. Preexisting HHV-6 antibody increased significantly in the half of patients with primary HHV-7 infection. HHV-7 DNA was detected in peripheral blood MNCs and plasma in the acute phase and persisted in MNCs thereafter.