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Cited by 462Cytomegalovirus and herpesvirus researchViral-associated cancers and disordersHerpesvirus Infections and Treatments

A population-based study of primary human herpesvirus 6 infection

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Zerr, Danielle M., Meier, Amalia S., Selke, Stacy S., Frenkel, Lisa M., Huang, Meei-Li, Wald, Anna, Rhoads, Margaret P., Nguy, Long +3 more·2005·New England Journal of Medicine
DOI 10.1056/nejmoa042207
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Abstract

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.

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Authors
Zerr, D. M., Meier, A. S., Selke, S. S., Frenkel, L. M., Huang, M.-L., Wald, A., Rhoads, M. P., Nguy, L., Bornemann, R., Morrow, R. A., & Corey, L.
Affiliations
  • University of Washington (US)
  • Fred Hutch Cancer Center (US)
ORCID
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
2005-02-24
Volume
352
Issue
8
Pages
768-776
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejmoa042207
OpenAlex
W2111044841
Cited by
462
References
13
Citations by year
2026: 10 · 2025: 16 · 2024: 17 · 2023: 18 · 2022: 15 · 2021: 20 · 2020: 22 · 2019: 24 · 2018: 24 · 2017: 26 · 2016: 28 · 2015: 22 · 2014: 27 · 2013: 28 · 2012: 23
FWCI
18.49
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health
  • National Institute of Allergy and Infectious Diseases (AI 30731, P01AI030731, K23AI001679, AI001679)
Topics
  • Health Sciences › Medicine › Epidemiology › Cytomegalovirus and herpesvirus research
  • Health Sciences › Medicine › Oncology › Viral-associated cancers and disorders
  • Health Sciences › Medicine › Epidemiology › Herpesvirus Infections and Treatments
Keywords
human herpesvirus 6, infant infection, siblings, roseola, febrile seizures, clinical features, fever, rash, diarrhea, sex differences
MeSH terms
Antibodies, Viral, Child, Preschool, DNA, Viral, Exanthema Subitum, Female, Fever, Humans, Immunoglobulin G, Immunoglobulin M, Infant, Infant, Newborn, Male, Prospective Studies, Risk Factors, Saliva, Sex Factors, Herpesvirus 6, Human, Incidence, Proportional Hazards Models, Survival Analysis, Polymerase Chain Reaction, Roseolovirus Infections

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