Fox, Julie Dawn; (1992) Studies of the epidemiology of human herpesvirus 6. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

A new human herpes virus was isolated in 1986 from patients with various lymphoproliferative disorders and was designated human herpes virus 6 (HHV6). This thesis describes work undertaken to define the epidemiology of HHV6 infection in order to determine any association of HHV6 infection with human disease. The close relationship of HHV6 with human cytomegalovirus and the interaction of HHV6 with other viruses are discussed. Work on the epidemiology and pathogenic significance of HHV6 depends on having sensitive and specific assays for antibody detection. The development of assays for the detection of HHV6 specific IgM and IgG antibody and the use of these assays to establish antibody prevalence levels in normal and patient population groups are described. Most adults were found to be HHV6 antibody positive and the majority of HHV6 infections in adults were due to reactivation or reinfection. Children were found to have been infected with HHV6 during the first year of life and the clinical consequences of primary HHV6 infection was investigated. HHV6 antibody prevalence and titre in adult patient groups was compared with controls and the results are discussed in the context of other published serological reports. In situ hybridization and immunohistochemical staining were used to determine the in vivo tissue tropism of HHV6 and to investigate any potential disease association of HHV6 infection. Amplification of HHV6 DNA by the polymerase chain reaction was used for the detection of HHV6 DNA in saliva samples and peripheral blood mononuclear cells from healthy individuals. A large proportion of salivary gland tissues and saliva samples was found to be HHV6 DNA positive, which may have implications for transmission of the virus. The results of a prospective study to investigate possible reactivation of HHV6 during pregnancy are presented. Samples were taken from pregnant women at various times during the antenatal and early postnatal period to determine any change in HHV6 antibody profile, HHV6 DNA in peripheral blood samples and shedding of HHV6 in saliva. The postulate is discussed that pregnant women reactivate HHV6 which results in increased salival shedding of the virus during the early postnatal period and thus transmission to their newborn offspring.

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