Estudo clínico-epidemiológico da infecção primária pelo herpesvírus humano tipo 6 em crianças menores de quatro anos de idade com doenças exantemáticas, Niterói, RJ

• Autor(a) principal: Vianna, Renata Artimos de Oliveira
• Data de Publicação: 2005
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da Universidade Federal Fluminense (RIUFF)
• Texto Completo: https://app.uff.br/riuff/handle/1/17258
• topic: Herpesvirus 6 Humano; Doenças exantemáticas; MEDICINA; CIÊNCIAS MÉDICAS; Infecção por herpesviridae; Epidemiologia; Exantema súbito; CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA

We investigated the clinical and epidemiological features of primary HHV-6 infection in children younger than 4 years old enrolled in a study designed to define the aetiology of rash diseases. The study was conducted between January 1998 and December 2006 at a general hospital and a large primary health care unit from the public health network of Niterói, Rio de Janeiro, Brazil. Each case was interviewed regarding measured or reported fever, respiratory symptoms, lymphadenopathy and other symptoms. Serum samples were collected from children with a disease of acute onset and were tested for measles, rubella, dengue virus, and human parvovirus using an enzyme immunoassay. Of the 320 study cases, 39 (12%) were IgM positive for dengue, 27 (8.4%) for parvovirus B19 and 2 (0.6%) for rubella. Three (0.9%) children were clinically diagnosed as streptococcal infection. Sera from 223 children, in whom measles, rubella, dengue fever and parvovirus B19 infections were excluded, were studied for anti-HHV-6 IgG and IgM antibodies using an indirect immunofluorescence test and 97 (43.5%)had evidence of primary HHV-6 infection. The age of onset peaked at 6-11 months and 75.3% of the HHV-6 infection occurred in children between 6-17 months. The distribution of the primary HHV-6 infection cases throughout the years and the monthly incidence seemed to be associated with the occurrence of rash diseases in children below 4 years of age. After exanthema, fever was the most prominent finding in primary HHV-6 infection cases, present in 93.8% of the HHV-6 cases. Inflamed tympanic membranes (8.2%) and febrile seizures (1% each) were less frequently associated with the HHV-6 cases. Only 21.1% of the HHV-6 cases had a typical roseola-like illness and 73.2% and 46.4%, respectively, fulfilled the criteria of a clinically measles and rubella suspected case. The accuracy of the IgM test to detect recent HHV-6 infection was 81%. Our study confirms the importance of HHV-6 infection as a cause of rashes in young children and highlights the difficulties of diagnosing a rash illness on clinical grounds alone.