A population-based study of primary human herpesvirus 6 infection
A population-based study of primary human herpesvirus 6 infection
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DOI：
10.1056/nejmoa042207
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发表时间：
2005-02-24
影响因子：
158.5
通讯作者：
Corey, L
中科院分区：
文献类型：
--
作者：
Zerr, DM;Meier, AS;Corey, L
背景：血清学研究表明，人类疱疹病毒6型（HHV-6）感染90%的2岁以下儿童。鲜为人知的是收购，病毒学过程中，HHV-6 infection.METHODS的临床表现：我们前瞻性研究了一个队列的277名儿童从出生到生命的头两年，以确定收购的HHV-6的模式。每周使用聚合酶链反应检测儿童唾液中的HHV-6 DNA。父母每天记录孩子的体征和症状。结果：130名儿童发生原发性HHV-6感染，12个月时累积百分比为40%，24个月时为77%。获得的高峰年龄在9至21个月之间。HHV-6的获得与女性性别（调整后的风险比，1.7; 95%置信区间，1.2至2.4）和有年长的兄弟姐妹（调整后的风险比，2.1; 95%置信区间，1.4至2.9）有关。在81名具有明确的HHV-6感染时间的儿童中，93%有症状，38%有医生。没有人有癫痫。与患有其他疾病的儿童相比，原发性HHV-6感染者更可能出现发热（P=0.003）、烦躁（P=0.02）、腹泻（P = 0.03）、皮疹（P=0.003）和玫瑰疹（P=0.002），并且更可能去看医生（P=0.003）。玫瑰疹发生在少数患者中，热性惊厥很少与原发性HHV-6感染相关。年长的兄弟姐妹似乎是HHV-6传播的来源。
BACKGROUND:Serologic studies indicate that human herpesvirus 6 (HHV-6) infects 90 percent of children by two years of age. Little is known about the acquisition, virologic course, and clinical manifestations of HHV-6 infection.METHODS:We prospectively studied a cohort of 277 children from birth through the first two years of life to define the pattern of acquisition of HHV-6. The children's saliva was tested weekly for HHV-6 DNA with the use of the polymerase chain reaction. Parents maintained a daily log of signs and symptoms of illness in their children.RESULTS:Primary HHV-6 infection occurred in 130 children, with cumulative percentages of 40 percent by the age of 12 months and 77 percent by the age of 24 months. The peak age of acquisition was between 9 and 21 months. The acquisition of HHV-6 was associated with female sex (adjusted hazard ratio, 1.7; 95 percent confidence interval, 1.2 to 2.4) and having older siblings (adjusted hazard ratio, 2.1; 95 percent confidence interval, 1.4 to 2.9). Among 81 children with a well-defined time of acquisition of HHV-6, 93 percent had symptoms, and 38 percent were seen by a physician. None had seizures. As compared with children who had other illnesses, those with primary HHV-6 infection were more likely to have fever (P=0.003), fussiness (P=0.02), diarrhea (P=0.03), rash (P=0.003), and roseola (P=0.002) and were more likely to visit a physician (P=0.003).CONCLUSIONS:The acquisition of HHV-6 in infancy is usually symptomatic and often results in medical evaluation. Roseola occurs in a minority of patients, and febrile seizures are infrequently associated with primary HHV-6 infection. Older siblings appear to serve as a source of HHV-6 transmission.