Turning to the question of formation of asymptomatic forms of infection caused by human herpes virus 6 variant B in children

Abstract

Laboratory markers of human herpesvirus 6A and 6B infection are detected with high frequency not only in patients with somatic pathology, but also in apparently healthy people. Up to the present moment mechanisms of occurrence of various forms of infection process (symptomatic and latent) caused by HHV-6 A/B are still unclear.

The aim of the study was to evaluate clinical and pathogenetic features of formation of asymptomatic forms of infection induced by HHV-6 A/B.

Material and methods. 479 children between 1 and 16 years old with acute primary (n=109), reactivated (n=209) and latent infections (n=56) caused by HHV-6A/B and 105 clinically healthy children were examined. The authors used general clinical methods; direct and indirect (ELISA) methods for HSV-1, VEB, CMV, HHV-6 [qualitative polymerase chain reaction (PCR) method, rapid culture method] diagnosis. The molecular genetic testing of DNA samples extracted from peripheral blood was also performed by determining single nucleotide polymorphism variants of the following genes: TLR9-1486 T>C, TLR3 908T>C, NLRP3 2107C>A; MXA G-88T, MXA C-123A, IFITM3 rs12252; TNF-238 G>A; TNFG-308A; CCR5 delta32, CCR5 -2554G>T, CCR5 -2459A>G.

Results and discussion. In 60% of cases there was no information about pre-existing HHV-6A/B infection in history of children with confirmed reactivated and latent HHV-6A/B infection. In 22% of cases there were indications of manifest clinical forms (among them: febrile seizure - 39%, exanthem subitum - 22%, respiratory form - 11%, infectious mononucleosis - 5%), and in 15% of cases there were signs of pre-existing acute respiratory disease. In 45% of apparently healthy children asymptomatic forms of infection induced by HHV-6 A/B was diagnosed. In children younger than 4 years with clinical manifestations of HHV-6A/B infection, the GT genotype for MxA -88 G> T (RR=5.0; p=0.04) and the CT genotype for MxA-123 C>A (RR=4.38; p<0.05) were significantly more frequently determined. Children with nonspecific clinical manifestations of HHV-6A/B infection were significantly more often carriers of the GT genotype for MXA -88 G>T (RR=2.96; p=0.04). In group of children 4 years and older with manifest forms of HHV-6A/B infection, the GG genotype for CCR5-2554 G>T was significantly more often detected (RR=1.89; p=0.047).

Conclusions. Acute primary HHV-6A/B infection in 60% of cases is asymptomatic. Progression of HHV-6A/B infection clinically manifest forms is determined by child's age at time of HHV-6 contamination, as well as by structural and functional characteristics of interferon-induced protein MxA and CC chemokine receptor type five.

Keywords:human herpesvirus types 6A and 6B, asymptomatic course, single nucleotide polymorphisms

Funding. The study had no sponsor support.

Conflict of interests. The authors declare no conflict of interests.

For citation: Melekhina E.V., Znoyko O.O., Abramov D.D., Muzyka A.D., Gorelov A.V. Turning to the question of formation of asymptomatic forms of infection caused by human herpes virus 6 variant B in children. Infektsionnye bolezni: novosti, mneniya, obuchenie [Infectious Diseases: News, Opinions, Training]. 2020; 9 (1): 78-87. doi: 10.33029/2305-3496-2020-9-1-78-87 (in Russian)

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CHIEF EDITOR
Aleksandr V. Gorelov
Academician of the Russian Academy of Sciences, MD, Head of Infection Diseases and Epidemiology Department of the Scientific and Educational Institute of Clinical Medicine named after N.A. Semashko ofRussian University of Medicine, Ministry of Health of the Russian Federation, Professor of the Department of Childhood Diseases, Clinical Institute of Children's Health named after N.F. Filatov, Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Deputy Director for Research, Central Research Institute of Epidemiology, Rospotrebnadzor (Moscow, Russian Federation)

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