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Journal of Clinical Microbiology, December 2007, p. 3972-3978, Vol. 45, No. 12
0095-1137/07/$08.00+0     doi:10.1128/JCM.01692-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Detection and Typing of Human Herpesvirus 6 by Molecular Methods in Specimens from Patients Diagnosed with Encephalitis or Meningitis

Norma P. Tavakoli,^1,2* Seela Nattanmai,^1, Rene Hull,¹ Heather Fusco,^1, Lela Dzigua,¹ Heng Wang,¹ and Michelle Dupuis¹

Wadsworth Center, New York State Department of Health, Albany, New York,¹ School of Public Health, SUNY Albany, Albany, New York²

Received 24 August 2007/ Returned for modification 5 October 2007/ Accepted 10 October 2007

Human herpesvirus 6 (HHV-6) was detected in specimens from patients hospitalized with symptoms of encephalitis or meningitis. A real-time PCR assay was developed which has a linear dynamic range of 5 to 5 x 10⁶ copies of HHV-6 and a sensitivity of five gene copies per reaction. While the assay detects both subtypes, HHV-6A and HHV-6B, it is specific and does not cross-react with a selected specificity panel. A total of 1,482 patient specimens, which were collected between 2003 and 2007, were tested; 26 specimens from 24 patients were found to be positive for HHV-6 by real-time PCR. The HHV-6 detection rate in this population was therefore 1.75%. The majority of the specimens tested (>95%) were cerebrospinal fluid (CSF) specimens. We were able to type 20 of the 26 positive specimens by conventional PCR and sequence analysis; all were HHV-6B. Forty-two percent of the patients were 3 years of age or younger, which may indicate a primary infection in these patients. Given the ages of the remaining patients (from 4 to 81 years), their infections were most probably due to virus reactivations. Where information was available, symptoms of patients included fever (71%), altered mental status (67%), and abnormal CSF profile (75%). Fifty percent of patients of 3 years of age or younger suffered from seizures. The detection of HHV-6 in specimens from patients diagnosed with encephalitis or meningitis, in the absence of a positive PCR result for other agents, strongly suggests a role for HHV-6 in the pathogenesis of these central nervous system diseases.

Published ahead of print on 17 October 2007.

Present address: Albany Medical Center, Albany, NY.

Present address: Regeneron, Rensselaer, NY.