Clinical Characteristics of Primary HHV-6B Infection in Children Visiting the Emergency Room
Clinical Characteristics of Primary HHV-6B Infection in Children Visiting the Emergency Room
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DOI：
10.1097/inf.0000000000002379
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发表时间：
2019-10-01
影响因子：
3.6
通讯作者：
Yoshikawa, Tetsushi
中科院分区：
文献类型：
--
作者：
Hattori, Fumihiko;Kawamura, Yoshiki;Yoshikawa, Tetsushi
目的：本队列研究基于美国先前的一项研究设计，旨在阐明原发性人类疱疹病毒 6B (HHV-6B) 感染的临床特征。方法：2014年6月至2016年5月期间，入组急诊室（ER）并接受血液检查的5岁以下发热儿童。结果：491 名患者中有 59 名 (12%) 被诊断为原发性 HHV-6B 感染。原发性 HHV-6B 感染患者的单纯性和复杂性热性惊厥发生率均显着高于未感染者（分别为 P < 0.001 和 P = 0.008）。原发 HHV-6B 感染的中位年龄为 15 个月。 59 名原发性 HHV-6B 感染患者中，47 名 (79.7%) 年龄小于 2 岁。比较了 2 岁以下和 2 岁以下 HHV-6B 感染患者的临床特征。年轻患者的明显感染（皮疹）频率明显较高（P = 0.01）。 2岁以上患者的中位白细胞（P = 0.01）和淋巴细胞（P < 0.001）计数显着低于年轻患者。结论：原发性 HHV-6B 感染占 ER 就诊人数的 12%。继发性热性惊厥，特别是复杂型，被认为是原发性 HHV-6B 感染疾病负担的主要原因。与以往报道相比，原发性 HHV-6B 感染发生的年龄较大，且老年患者隐性感染的频率较高。
Objective: This cohort study, based on the design of a prior study in the United States, was conducted to elucidate the clinical features of primary human herpesvirus-6B (HHV-6B) infection. Methods: Between June 2014 and May 2016, febrile children younger than 5 years who visited the emergency room (ER) and underwent blood examination were enrolled in this study. Results: Fifty-nine (12%) of the 491 patients were diagnosed with primary HHV-6B infection. The rates of both simple and complex febrile seizure were significantly higher in patients with primary HHV-6B infection than in those without (P < 0.001 and P = 0.008, respectively). The median age at primary HHV-6B infection was 15 months. Forty-seven (79.7%) of the 59 patients with primary HHV-6B infection were younger than 2-year-old. Clinical features were compared between HHV-6B-infected patients older and younger than 2 years. The frequency of apparent infection (exanthema subitum) was significantly higher in the younger patients (P = 0.01). The median leukocyte (P = 0.01) and lymphocyte (P < 0.001) counts in the patients older than 2 years were significantly lower than those in the younger patients. Conclusions: Primary HHV-6B infection accounted for 12% of ER visits. Secondary febrile seizures, in particular the complex type, were considered to be a major contributor to the disease burden of primary HHV-6B infection. The timing of primary HHV-6B infection occurred at older ages than in past reports, and the frequency of inapparent infection was higher in older patients.