Human herpesvirus 6 infection in children hospitalized with the clinical manifestations of acute respiratory disease


Gorelov A.V., Muzyka A.D., Melekhina E.V., Petukhova E.V., Shipulina O.Yu., Domonova E.A., Lysenkova M.Yu., Chugunova O.L., Akopyan A.S., Barykin V.I.

1Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; 2Honored Academician N.F. Gamaleya National Research Center of Epidemiology and Microbiology, Ministry of Health of Russia, Moscow, Russia; 3N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia; 4G.N. Speransky City Children’s Clinical Hospital Nine, Moscow Healthcare Department, Moscow, Russia; 5Khimki Central Clinical Hospital, Khimki, Moscow Region, Russia
Objective. To optimize the diagnosis of active human herpesvirus 6 (HHV-6) infection in children hospitalized with clinical presentations of acute respiratory disease.
Subjects and methods. Examinations were made in 567 children admitted to hospital with the clinical manifestations of acute respiratory infection (ARI) and 100 clinically healthy children at the age of 1 year to 16 years. Herpesvirus infections were diagnosed using enzyme immunoassay, real-time polymerase chain reaction, rapid culture (RC), and indirect immunofluorescence test.
Results. The laboratory markers of HHV-6 infection were observed in 80% of the examinees; one third (n = 136) of them were diagnosed with acute primary and reactivated infection. Acute primary forms of infection are more frequently encountered in children during the first three years of life; the course of infection with nonspecific features is more typical for children older than 3 years of age. The presence of blood virus DNA (more than 100 copies/105 cells) in combination with the release of early antigens (RC) testifies to the active form of HHV-6 infection. A management algorithm has been elaborated for children with ARI and active forms of HHV-6 infection.
Conclusion. The detection of active HHV-6 infection in children hospitalized with ARI requires an integrated diagnostic approach using quantitative determination of blood HHV-6 DNA and early viral proteins (RC).

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About the Autors


For correspondence:
Еlena V. Melekhina – Cand. Med. Sci., Associate Professor in Pediatrics, Senior Researcher, Clinical Department of Infectious Diseases, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being
Address: 3a, Novogireevskaya St., Moscow 111123, Russia
Теlеphone: +7(495) 672-11-58
E-mail: e.melekhina@mail.ru
Information about the authors:
Prof. Alexandr V. Gorelov, MD, Corresponding Member of the Russian Academy of Sciences; Head, Clinical Department of Infectious Diseases, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; е-mail: crie@pcr.ru
Anna D. Muzyka, Junior Researcher, Clinical Department of Infectious Diseases, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; е-mail: nikolitch-anna@yandex.ru
Evgeniya V. Petukhova, Junior Researcher, Clinical Department of Infectious Diseases, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; е-mail: tymrf@mail.ru
Olga Yu. Shipulina, Cand. Med. Sci., Head, Division of Molecular Diagnostics, Department of Molecular Diagnostics and Epidemiology, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; е-mail: olga.shipulina@pcr.ms
Elvira A. Domonova, Cand. Biol. Sci., Senior Researcher, Department of Molecular Diagnostics and Epidemiology, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; e-mail: elvira.domonova@pcr.ms;
Mariya Yu. Lysenkova, Cand. Biol. Sci., Researcher, Laboratory for Epidemiology of Opportunistic Infections, 2Honored Academician N.F. Gamaleya National Research Center of Epidemiology and Microbiology, Ministry of Health of Russia, Moscow, Russia; е-mail: happydoctor-mk@mail.ru
Olga L. Chugunova, МD, Professor, Аcademician V.A. Tabolin Department of Hospital Pediatrics, Pediatric Faculty, N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia; е-mail: ol_chugunova@mail.ru
Alexandr S. Akopyan, Head, Department of Infectious Disease Ten, G.N. Speransky City Children’s Clinical Hospital Nine, Moscow Healthcare Department, Moscow, Russia; е-mail: alexandr_akopyan@bk.ru
Vadim I. Barykin, Head, Children’s Infectious Department, Khimki Central Clinical Hospital, Khimki, Moscow Region, Russia; е-mail: hcgb.muz.dio@mail.ru


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