THE FREQUENCY AND DIAGNOSTIC VALUE OF HHV-6 DETECTION IN CSF OF IMMUNOCOMPETENT CHILDREN



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Abstract

BACKGROUND: Human herpes virus type 6 (HHV-6) is a widespread pathogen well known as the causative agent of exanthem subitum in children. However, little is known about the frequency and significance of HHV-6 detection in cerebrospinal fluid (CSF) and its role in the development of meningoencephalitis in immunocompetent children.

AIM: is to evaluate the frequency and diagnostic value of detecting HHV-6 DNA in cerebrospinal fluid in immunocompetent children with suspected meningoencephalitis.

METHODS: All cases of CSF examination for HHV-6 by qualitative PCR during 2007-2018 in Filatov’s children clinical hospital #5 of Saint-Petersburg, Russia were retrospectively studied. The cases of HHV-6 DNA detection in cerebrospinal fluid were analyzed and final diagnoses were made.

RESULTS: Over 12 years, CSF of 712 patients with suspected meningoencephalitis were examined on HHV-6. In only 2.9% of cases, HHV-6 DNA was detected in the CSF. When analyzing 15 medical histories of children with HHV-6, it was revealed that 7 children did not have pathological changes in CSF, while most of them had a typical clinical course of Exanthem subitum or fever without rash. In a group of 8 patients with pathological changes in CSF, 2 cases of HHV-6 meningoencephalitis were detected. Thus, detection of HHV-6 DNA in CSF in immunocompetent children is rare and in majority of cases (86%) does not indicate HHV-6 meningoencephalitis.

CONCLUSION: Over 12 years, out of 712 patients with suspected meningitis and/or encephalitis, HHV-6 meningoencephalitis was confirmed in only 2 infants (0.3%). HHV-6 DNA can be detected in unchanged CSF in primary HHV-6 infection, which must be taken into account when making a diagnosis and decision of antiviral therapy.

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About the authors

Mikhail A. Nikolskiy

ПСПбГМУ им.акад.И.П.Павлова

Author for correspondence.
Email: nicolm@inbox.ru
ORCID iD: 0000-0001-9766-2577
SPIN-code: 1599-1345

ассистент кафедры педиатрии ПСПбГМУ им.акад.И.П.Павлова

Russian Federation, 197022, Санкт-Петербург, Льва Толстого 6/8

Dmitriy A. Lioznov

Email: dlioznov@yandex.ru

Eugeniy U. Gorelic

Email: e.gorelik@mail.ru

Tatyana V. Vishnevskaya

Email: vishnevskaya2111@mail.ru

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