HHV6 Detection in Pediatric CSF: Real Pathogen or Incidental Finding?

Reviewed by Dr. Michael Payne, Providence Health Care

Molecular detection of human herpesvirus type 6 (HHV6) in the cerebrospinal fluid (CSF) of children can be challenging. HHV6 can cause acute infection, reactivation or can be inherited chromosomally integrated (iciHHV6). This study determined the prevalence of HHV6, including iciHHV6, in CSF and compare the clinical and laboratory characteristics in the pediatric patient cohort. Overall, the prevalence of HHV6 and iciHHV6 was 2.4% (65/2703) and 0.85% (23/2703), respectively. Twenty-one (91.3%) patients with iciHHV6 and 12 (33.3%) without ici-HHV6 were determined to have an incidental detection of HHV6, not associated with presenting symptoms. Overall, the positive predictive value of molecular detection of HHV6 for CNS disease was 28.8%. Molecular detection of HHV6 in pediatric CSF is not always associated with HHV6 CNS disease infection and results need to be correlated with clinical presentation.


Diagn Microbiol Infect Dis. 2023 Oct;107(2):116029. doi: https://doi.org/10.1016/j.diagmicrobio.2023.116029

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