<p>First Report on HHV-6 Infection Among HIV-Infected Individuals Residing in Surabaya, Indonesia</p>

Abstract

Background: Morbidity and mortality from acquired immunodeficiency syndrome (AIDS) are often associated with the reactivation of a herpes virus infection. Human herpesvirus-6 (HHV-6) is usually common in childhood infections that remain latent and can act as opportunists during immunosuppression to reactivate and cause disease. In human immunodeficiency virus (HIV)-infected patients, the impact of HHV-6 infection can be an upregulator of HIV replication and accelerate progress towards AIDS. However, studies on HHV-6 infection have never been done in Surabaya, Indonesia. Purpose: To determine the presence of HHV-6 infection among HIV-infected individuals residing in Surabaya, Indonesia. Patients and Methods: Plasma and peripheral blood mononuclear cells (PBMCs) were collected from 85 HIV-infected individuals in Universitas Airlangga Hospital, Surabaya, as well as 85 healthy controls. DNA extracted from PBMCs was subjected to PCR to determine HHV-6 infection, while plasma of HIV-infected individuals was used for viral RNA quantification using real-time PCR. Results: HHV-6 infection was detected in 17.6% (15/85) of HIV-infected individuals, and in 3.53% (3/85) of healthy controls. Thus, HHV-6 infection was more likely to be found in HIVinfected individuals than in healthy controls (odds ratio 5.85; 95% confidence interval, 1.6-21). The HHV-6B was the most common subtype identified in both HIV-infected individuals (12/15) and healthy controls (3/3). The HHV-6A and co-infection between HHV-6A and HHV-6B were only found in HIV-infected individuals (2/15 and 1/15, respectively). Viral RNA load of HIV-infected individuals was not correlated to HHV-6 infection. Conclusion: Our results indicate the emergence of HHV-6 infection among HIV-infected individuals residing in Surabaya, Indonesia, and the risk of HHV-6 infection was higher in HIV-infected individuals than in healthy controls.

Detection of Human Herpesviruses in Sera and Saliva of Asymptomatic HIV-Infected Individuals Using Multiplex RT-PCR DNA Microarray

“…For HIV-infected children, a study in Brazil reported that HHV-6 was detected in 18% of the oral mucosa [ 13 ]. Other studies using plasma samples have reported that the frequency of HHV-6 ranges from 7% to 32.2% [ 1 , 52 , 53 ]. HHV-6 infection/reactivation in HIV/AIDS individuals causes disseminated infections in many organs, leading to a variety of diseases, including encephalitis, pneumonitis, multiple sclerosis, non-Hodgkin’s and Hodgkin’s lymphomas, and other serious diseases [ 3 , 54 ].…”

Frequency evaluation and molecular characterization of HHV‐6 and HHV‐7 among children under 5 years with fever and skin rash

“…Both variants of HHV‐6 are related to neurological diseases, although they have different tropisms and pathogenicity 8 . Following initial infection, HHV‐6 may spread in peripheral blood cells and reactivate later in immunocompromised patients, and this may be criteria to classify the virus as an opportunistic pathogen 11 . HHV‐6A and HHV‐6B are also responsible for post‐transplant infection complications in patients undergoing kidney and stem cell transplantation.…”

“…8 Following initial infection, HHV-6 may spread in peripheral blood cells and reactivate later in immunocompromised patients, and this may be criteria to classify the virus as an opportunistic pathogen. 11 HHV-6A and HHV-6B are also responsible for post-transplant infection complications in patients undergoing kidney and stem cell transplantation. They have been observed in bone marrow and solid tissue transplant recipients.…”