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Clinical and Diagnostic Laboratory Immunology, March 2002, p. 388-393, Vol. 9, No. 2
1071-412X/02/$04.00+0 DOI: 10.1128/CDLI.9.2.388-393.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.
Neutralizing Antibody Responses to Human Herpesviruses 6 and 7 Do Not Cross-React with Each Other, and Maternal Neutralizing Antibodies Contribute to Sequential Infection with These Viruses in Childhood
Mariko Yoshida,1* Sadayoshi Torigoe,2 Kumiko Ikeue,1 and Masao Yamada1
Department of Virology, Okayama University Graduate School of Medicine and Dentistry, Okayama,1
Yokkaichi Social Insurance Hospital, Mie, Japan2
Received 8 August 2001/
Returned for modification 2 November 2001/
Accepted 28 November 2001

ABSTRACT
Seroprevalence of human herpesvirus 6 (HHV-6) and HHV-7 infections
is very high throughout the world, and almost all people are
exposed first to HHV-6 and second to HHV-7 in their childhood.
However, it is not clear whether the neutralizing (NT) antibody
response between each virus is cross-reactive or not. To elucidate
the NT antibody response between each virus, 55 serum samples
from an adult group (subjects 22 to 88 years old) and 60 serum
samples from a young group (subjects 2 to 18 years old) were
examined by a dot blot method for detecting viral late antigen.
Thirty-nine serum samples obtained from cord bloods and a few
serum samples obtained from pediatric patients with exanthem
subitum were also examined to assess the maternal transferred
NT antibodies against each virus. The NT antibody titers against
HHV-7 in the adult group remained high throughout all the individuals,
and none were negative. Those against HHV-6 were high values
in the young group but low values, including negative values
(three samples), in the adult group. These results suggested
that the NT antibody response to either HHV-6 or HHV-7 in each
individual was specific to each virus and did not cross-react
with each other. In the adult group, the NT antibody response
to HHV-6 decreased, while that to HHV-7 remained high throughout
all the individuals. Maternal transferred NT antibody titers
against HHV-7 were higher and remained longer after birth than
those of HHV-6, and these findings were in accord with the clinical
observation that HHV-6 infection usually occurs earlier than
HHV-7 infection.

INTRODUCTION
Human herpesvirus 6 (HHV-6) (
19) and HHV-7 (
9) have recently
been discovered as etiologic agents of exanthem subitum (roseola).
HHV-6 and HHV-7 are T-lymphotropic viruses and have been classified
as betaherpesviruses. HHV-6 was first isolated from the peripheral
blood lymphocytes of patients with AIDS (
19) and has been divided
into two variants, HHV-6A and HHV-6B (
1,
2). HHV-7 was first
isolated from the peripheral blood lymphocytes (
9) and the saliva
of healthy adults (
5,
10,
12,
23,
27). Clinically, HHV-6B and
HHV-7 are the common etiologic agents of exanthem subitum (roseola)
(
24,
29), but diseases caused by HHV-6A are less apparent. While
diseases caused by primary infection of either HHV-6 or HHV-7
in childhood are usually not fatal, HHV-6 and HHV-7, as well
as the other members of the herpesviruses, are thought to establish
latent, life-long infection. It has been reported that HHV-6
may contribute to life-threatening diseases in immunosuppressed
conditions such as organ transplant and AIDS (
3,
4,
6,
7,
16)
and to drug-induced hypersensitivity syndrome (
8,
21,
22,
25).
Several investigators have reported that HHV-7 is easily isolated
from the saliva of individuals who have antibodies to HHV-7
(
10,
23). However, it is unknown which diseases can be caused
by reactivated HHV-7.
Serologic studies showed that seroprevalence of HHV-6 and HHV-7 infections are very high throughout the world and that almost all people are exposed first to HHV-6 and second to HHV-7 in their childhood (17). Several serologic studies for detection of antibodies to either HHV-6 or HHV-7 were performed by indirect immunofluorescent (IF) antibody assay (IFA), enzyme-linked immunosorbent assay (ELISA), neutralization, radioimmunoprecipitation, and Western blotting (11, 17, 28). The neutralizing (NT) antibody response is thought to be important in preventing infection from these viruses. However, there have been few comparative studies among these reports on the humoral antibody response between HHV-6 and HHV-7, and none has reported on the cross-reactive response based on the NT antibodies between HHV-6 and HHV-7 in individuals. These facts prompted us to investigate the cross-reactive response of NT antibodies between each virus and to assess the maternal transferred NT antibodies. In this report, we thought that it was important to determine the degree of immunological cross-reactivity between HHV-6 and HHV-7 based on the NT antibodies, which have taken an important role in the prevention of infection. In order to assess the antibody response to each virus, we established a dot blot method for detecting the NT antibody (26, 28) and an ELISA method for detecting the immunoglobulin G (IgG) and IgM antibodies (32). Here, we describe the following. (i) NT antibody responses between HHV-6 and HHV-7 are specific and do not cross-react to each other. (ii) NT antibody response to HHV-6 decreases with aging, while that to HHV-7 is maintained highly throughout all individuals of all ages. (iii) Maternal transferred NT antibodies against HHV-6 and HHV-7 contribute to the sequential infection between each virus.

MATERIALS AND METHODS
Serum samples.
Sixty serum samples were selected from healthy individuals in
different age groups from 2 to 18 years old (as the young group)
who had had a medical examination within the 3 months from February
to May in 1998 at Shingu Municipal Hospital, Shingu, Japan.
Fifty-five serum samples were also selected from healthy individuals
in different age groups from 22 to 89 years old (as the adult
group) who had had a medical examination within the 3 months
from February to May in 1996 at Tsukazaki Hospital, Himeji,
Japan. Thirty-nine serum samples obtained from cord blood specimens
were selected to evaluate the maternal NT antibody, which was
collected in January 2001 at Sun Clinic, Okayama, Japan under
informed consent from the mothers. Sequential serum samples
were obtained from five pediatric patients with exanthem subitum
who were 1 month to 1.5 years old and who had had a medical
examination within the 4 years from 1992 to 1996 at Shingu Municipal
Hospital under informed consent from their mothers. Thirty serum
samples from pediatric patients from 5 months to 1.7 years old
who were negative for either anti-HHV-6 or -7 antibody described
below were selected as negative reference samples for determining
the cutoff values for the ELISA for IgG [ELISA(IgG)] and ELISA(IgM).
These samples were also collected at Shingu Municipal Hospital
under informed consent from the mothers. All of the serum samples
were stored at -20°C before use.
Host cells.
Fresh cord blood mononuclear cells (CBMCs) were prepared by centrifugation through a Ficoll-Conray gradient from heparinized samples and cultured for 3 days in RPMI 1640 medium containing 10% heat inactivated fetal bovine serum, recombinant human interleukin-2 (0.1 U/ml; GIBCO BRL Life Technology Inc., Grand Island, N.Y.), and phytohemagglutinin (5 µg/ml; Sigma Chemical Co., St. Louis, Mo.) at 37°C in a 5% CO2 incubator. After 3 days, the CBMCs were infected with the virus and cultured for different experiments in RPMI 1640 medium containing the above reagents.
Preparation of virus stocks.
The Z29 strain of HHV-6B and the SB strain of HHV-7 were used throughout this study and prepared as described elsewhere (26, 31). The cells infected with each virus were cocultivated with uninfected cells at a ratio of 1:5 for 7 days. Virus stocks were prepared by centrifugation of the culture fluids at 2,000 x g for 10 min and stored at -80°C. Titration of the virus stocks was performed by an end point dilution method using a dot blot assay (30, 31). In brief, 25 µl of the CBMCs (adjusted to 5 x 106 cells/ml) was divided into each well of a 96-well microtiter U-bottom plate. The CBMCs were then infected with 25 µl of the virus preparation (in 10-fold dilution series) and incubated for 7 days at 37°C in a 5% CO2 incubator. After incubation, the supernatant medium was removed and the cells were washed with phosphate-buffered saline (PBS) (pH 7.4). A dot blot assay to detect the viral antigens is described below. After treatment with Lumi-Phos 530, the membrane was exposed to Fuji RX-U film. The 50% cell culture infectious dose was calculated according to the method of Reed and Muench (18).
IFA.
An IFA described elsewhere (30) was performed to determine the titer of either anti-HHV-6 or -7 antibody in human serum samples. In brief, HHV-6- or -7-infected CBMCs were mounted on a 14-well slide, dried, and kept at -20°C in a freezer before use. Each serum was diluted 1:10 in PBS to prevent nonspecific reactions, and then twofold serial dilutions of the 1:10-diluted samples were made. The diluted samples were applied to each well of the slide fixed with acetone. The slides were incubated at 37°C for 30 min and washed in PBS for 15 min three times. The fluorescein isothiocyanate-conjugated goat anti-human IgG F(ab')2 antibody (Cappel, West Chester, Pa.) was diluted 1:100 in PBS and added to each well of the slide. After 30 min of incubation at 37°C, the slides were washed and examined with a fluorescence microscope. The end point of the positive fluorescence was determined visually at a low magnification, and the IFA antibody titers were calculated as the reciprocal of the serum dilution.
Dot blot method for determining the NT antibody titers to HHV-6 and HHV-7.
A dot blot method described elsewhere (26, 32) was performed to determine the titers of NT antibody to HHV-6 and -7. In brief, 25 µl of serial twofold serum dilutions or medium without sera (control) were prepared on each well of a 96-well microtiter U-bottom plate and mixed with equal volumes of virus strains of HHV-6 or HHV-7 containing 2 x 104 50% tissue culture infectious doses/ml. After the microtiter plate was incubated for 1 h at 37°C in a CO2 incubator, 50 µl of CBMCs (2.5 x 106 cells/ml) was added to each well and centrifuged at 800 x g for 1 h. For removing the added sera, 100 µl of medium was added to each well of the plate and centrifuged at 800 x g for 5 min, and about 180 µl of the supernatant was aspirated. Two hundred microliters of medium was added to each well of the plate, and the microtiter plate was incubated for 7days at 37°C in a CO2 incubator.
To monitor the virus growth in each well, a dot blot antigen detection was performed as described previously (26, 30). In brief, after 7 days of incubation the microtiter plate was centrifuged at 500 x g for 10 min. The supernatant medium was removed and the cells were washed with PBS including Mg2+ and Ca2+ [PBS(+)] (pH 7.4). One hundred and eighty microliters of lysis buffer (20 mM Tris, 0.5 M NaCl, and 0.5% Nonidet P-40 [pH 7.5]) was added to each well. The cell lysates were spotted onto a nylon membrane (Boehringer Mannheim Biochemica, Indianapolis, Ind.), washed with blocking solution, and incubated with one of the monoclonal antibodies (MAb) described below overnight at 4°C. The membrane was washed, incubated with anti-mouse IgG-alkaline phosphatase conjugate (Sigma Chemical Co.), treated with Lumi-Phos 530 (Boehringer Mannheim Corporation), and exposed to Fuji RX-U film.
MAb.
MAb to HHV-6 and HHV-7 were established in our laboratory (26) and characterized by radioimmunoprecipitation. For monitoring HHV-6 replication, MAb TK-2, which recognizes a 135-kDa late polypeptide, was used. MAb TK-2 reacts to both variants of HHV-6. For HHV-7, MAb IK-3, which recognizes a 125-kDa corresponding polypeptide, was used. MAb IK-3 is specific to HHV-7.
Antigen preparation for ELISA.
The CBMCs infected with each virus of HHV-6 (Z29 strain) or HHV-7 (SB strain) were cultured for 5 to 7 days and harvested in 15-ml conical tubes at the period when the numbers of IF positive cells had reached almost 80%. The infected cells were pelletted down by centrifugation at 800 x g for 10 min, washed with PBS(+) (pH 7.4), and then centrifuged. The lysis buffer (20 mM Tris, 0.5 M NaCl, and 0.5% Nonidet P-40 [pH 7.5]) was added to each pellet at four times the pellet volume. The uninfected CBMCs were cultured for 6 days and prepared for control antigen the same way as described above.
ELISA.
Wells of a microplate (Nunc Immunoplate II; Nunc, Aarhus, Denmark) were coated with 50 µl of appropriate dilutions in PBS(+) of each virus or control antigen overnight at 4°C. After coating, the wells were washed and blocked for 30 min at room temperature by adding 200 µl of the blocking solution [PBS(+) containing 5% skim milk]. After discarding the blocking solution, 50 µl of serum diluted in the blocking solution (1:100 for IgG and 1:25 for IgM) was added to wells of the plate and incubated at 37°C for 2 h. The plate was washed five times with 200 µl of the blocking solution. Then, 50 µl of alkaline phosphatase-conjugated goat anti-human IgG (
-chain specific) F(ab')2 fragment (Sigma Chemical Company) or alkaline phosphatase-conjugated goat anti-human IgM (µ-chain specific) F(ab')2 fragment (Sigma Chemical Company) diluted in the blocking solution (1:1,000) was added to each well of the plate. After 2 h of incubation at 37°C, the plate was washed five times with 200 µl of the blocking solution and twice with PBS(+). Seventy-five microliters of substrate, p-nitrophenylphosphate in diethanolamine buffer (alkaline phosphatase substrate kit [Bio-Rad]) was added to each well of the plate, and the plate was incubated at 37°C for 1 h. Then, the reaction was stopped by adding 75 µl of 0.4 M NaOH, and the absorbance of each well at 405 nm was read with the microplate reader (model 550; Bio-Rad). The results (net absorbance) were expressed as the absorbency reading of each of the viral-antigen-coated wells minus the absorbency reading for the wells coated with control antigen.
For ELISA(IgG) antibody, the absorbance readings (mean ± standard deviation [SD]) for HHV-6 and HHV-7 obtained from about 30 negative reference serum samples of pediatric patients were 0.052 ± 0.067 and 0.027 ± 0.034, respectively. All of the samples studied were negative for IF and NT antibody titers against HHV-6. These samples were also negative for IF antibody against HHV-7, and for eight of these samples the titer of NT antibody against HHV-7 was under 1:8. Studied samples with net absorbance readings of
3 SD above the mean absorbance of the negative reference sera were considered reactive for anti-HHV-6 or HHV-7 antibody. The cutoff values for HHV-6 and -7 were determined with the absorbance readings of 0.26 and 0.13, respectively. For ELISA(IgM) antibody, about 20 negative reference serum samples which were negative for IF, NT, and ELISA(IgG) antibodies against HHV-6 and HHV-7 were selected from reference sera for ELISA(IgG) antibody. The absorbance readings (mean ± SD) for HHV-6 and HHV-7 obtained from these sera were 0.049 ± 0.030 and 0.033 ± 0.027, respectively, and the cutoff values for HHV-6 and -7 were determined with the absorbance readings of 0.14 and 0.12, respectively.

RESULTS
NT antibody responses against HHV-6 and HHV-7 do not cross-react with each other.
First, we compared the NT, IF, and ELISA(IgG) antibody titers
against HHV-6 and HHV-7 in 115 serum samples, including 55 serum
samples from the adult group and 60 serum samples from the young
group. A histogram based on each antibody titer against these
viruses is shown in Fig.
1. The NT antibody responses against
HHV-6 and HHV-7 showed different distributions between each
virus. The NT antibody titers against HHV-7 were high throughout
individuals of all ages, ranging from 1:8 to 1:>512 (geometric
mean titer = 2
5.64). A few samples were negative for those antibodies
in the young group, but none were negative in the adult group.
In contrast, the NT antibody titers against HHV-6 in the young
group (geometric mean titer = 2
4.52) were high and comparable
to those of HHV-7 in the young group (geometric mean titers
= 2
5.63), while significantly low titers, including negative
titers (ranging from 1:<1 to 1:64), were observed in the
adult group (geometric mean titer = 2
2.64). No significant difference
in distribution patterns of either IF antibody or ELISA(IgG)
antibody titers was observed between HHV-6 and HHV-7, although
these distribution patterns were generally higher in the young
group than in the adult group.
Second, to further elucidate the humoral antibody responses
between HHV-6 and HHV-7 in each individual, we analyzed the
scattergrams based on the NT, IF, and ELISA(IgG) antibodies
between each virus (Fig.
2). The NT antibody responses between
each virus were distinct in each individual. The sera with high
titers of anti-HHV-7 antibodies do not always have high titers
of anti-HHV-6 antibodies, while some sera negative for anti-HHV-6
NT antibodies have high titers for anti-HHV-7 antibodies. Namely,
the NT antibodies between HHV-6 and HHV-7 did not correlate
in each individual (Wilcoxon signed rank test,
P < 0.01;
Spearman rank correlation,
P > 0.01). Figure
2 shows that
the IF and ELISA(IgG) antibody titers in each individual did
not apparently correlate either.
These results revealed that the NT antibody response to either
HHV-6 or HHV-7 in each individual was specific to each virus
and that they did not cross-react with each other.
Maternal transferred NT antibodies against HHV-6 and HHV-7 contribute to the sequential infection between each virus.
First, 39 serum samples obtained from cord blood specimens were used to evaluate the NT antibody titers against HHV-6 and HHV-7 transferred from mothers to children (Fig. 3). The transferred NT antibody titers against HHV-7 (geometric mean titer = 27.03) were higher than those against HHV-6 (geometric mean titer = 25.22) among almost all the samples. The ELISA(IgG) antibody titers of antibodies to HHV-6 and HHV-7 did not represent a significant difference (data not shown). These agree well with the results described above.
Second, we monitored the NT antibody titers against these viruses
in five children with exanthem subitum. The ELISA(IgM) antibodies,
as well as the IF antibody and ELISA(IgG) antibodies, were also
examined to determine the primary infection of these viruses,
and the results are shown in Fig.
4. The titers of NT antibody
against HHV-7 in early time point samples obtained sequentially
were maintained higher than those of HHV-6 among three samples
(samples 1, 15, and 22, shown in Fig.
4). Among them, two samples
(samples 1 and 22) represented seroconversion against HHV-6
after the NT antibody titers decreased to almost negative values.
The ELISA(IgM) antibody response against HHV-6 was detected
temporally at the same time of elevation of the NT and IF antibodies
and just before elevation of the ELISA(IgG) antibodies. One
sample (sample 15, shown in Fig.
4) revealed reversion of antibody
titers between the NT and IF antibodies. The titers of NT antibody
against HHV-6 were lower than those of HHV-7 and almost negative,
while the titers of IF antibody against HHV-6 were higher than
those against HHV-7. These data suggest that the IF antibody
response is not useful to elucidate the transferred antibody
that prevent infection with these viruses. In the case of two
samples (samples 10 and 27, shown in Fig.
4), the NT antibodies
against HHV-6 were maintained higher than those of HHV-7. It
was difficult to determine which was the transferred antibody
from the mother or the primary infection of HHV-6. However,
these two samples revealed an apparent seroconversion against
HHV-6, because the ELISA(IgM) antibodies were found in the first
point of the sequentially obtained samples. In the case of sample
10, the patient was diagnosed with exanthem subitum twice. These
data revealed that this patient experienced exanthem subitum
caused first by HHV-6 infection and second by HHV-7 infection.
It is not easy to collect serum samples from subjects within
6 months after birth. In this work, only 15 serum samples were
obtained from eight patients in this periods. We have calculated
the geometric mean titers of these samples. Among them, 7 serum
samples were apparently negative for HHV-6 and 11 serum samples
were also negative for HHV-7. The geometric mean titers of antibodies
against HHV-6 and HHV-7 were 2
1.10 and 2
2.14, respectively.
We also selected serum samples within 3 months after birth which
were apparently negative for both viruses and calculated the
geometric mean titers. The geometric mean titers were 2
1.26 and 2
4.04 for HHV-6 (three serum samples) and HHV-7 (five serum
samples), respectively. Within 6 months after birth, two patients
experienced exanthem subitum caused by HHV-6. In case of one
patient (data not shown), it occurred within 3 months, and HHV-6
was isolated from peripheral blood mononuclear cells. Although
sample numbers were not enough to conclude that the protective
effect of HHV-7 maternal transferred NT antibody plays a role,
these results suggested that the average titer of NT antibodies
against HHV-7 in cord blood was approximately 2 logs higher
than those against HHV-6 and that HHV-7 maternal transferred
NT antibodies were maintained higher than those of HHV-6 within
6 months after birth.
These results suggested that the maternal transferred NT antibody response to HHV-7 was maintained at a high level from just after birth and was delayed in decreasing, while those to HHV-6 were maintained at considerably lower levels from just after birth and decreased faster than those to HHV-7. These findings were in accord with the clinical observation that HHV-6 infection usually occurs earlier than HHV-7 infection.

DISCUSSION
Seroepidemiology of HHV-6 and HHV-7 has been based on the antibody
titers determined by the IFA or ELISA methods. There have been
some reports on the NT antibody assay for HHV-6, conventionally
determining the end points by cytopathic changes or IF. A few
of these were comparative studies of the titers of NT antibodies
against HHV-6 and HHV-7 in each individual (
26,
32). In the
present study, we performed a dot blot method for viral late
antigen detection to assess the NT antibodies described elsewhere
(
26,
32), because this method takes advantage of a reliable,
reproducible and visible end point. This report precisely demonstrated
the humoral immune responses based on the NT antibodies between
HHV-6 and HHV-7 in each individual. The results suggest that
the immunological cross-reactivity between HHV-6 and HHV-7 is
not exhibited in the NT antibodies and that the neutralizing
epitopes of these two viruses are apparently distinct (
14,
20).
Serologic studies also showed that almost all individuals are
exposed first to HHV-6 and second to HHV-7 in their childhood,
acquire the NT antibodies against these viruses, and keep them
at high levels for 2 or 3 decades after primary infection (
11,
13,
17,
28,
32). However, an interesting result in the present
report was that the NT antibody response to HHV-6 was kept at
significantly lower level than that to HHV-7. The continuation
at high levels of anti-HHV-7 NT antibody titers may contribute
to the finding that it was easy to isolate HHV-7 from adult
saliva (
10). In contrast, it was difficult to isolate HHV-6
from any source in healthy adults, while HHV-6 DNA was detected
in adult saliva by PCR as well as HHV-7. That is, these results
suggested that the continuous reactivation of HHV-7 might have
an important role for keeping the NT antibody response at a
high level. Serological investigation based on the NT antibody
against HHV-6 will become a useful tool to determine the reactivation
of HHV-6, because of the lower levels of anti-HHV-6 NT antibody
response. Recently, drug hypersensitivity syndrome (DHS), which
is a severe idiosyncratic reaction associated with drug therapy,
has focused on the relationship with the reactivation of HHV-6
(
8,
21,
22,
25). We plan a retrospective study to investigate
the reactivation of HHV-6 associated with DHS using sera obtained
from DHS patients.
In this report, we demonstrated that maternal transferred NT antibodies have an important role in preventing infection with each virus and that the levels of these transferred-NT antibody titers contributed to the sequential infection with each virus; namely, HHV-6 infects first and HHV-7 infects second. We also used the sera obtained from cord blood specimens to examine the maternal transferred NT antibody against HHV-6 and HHV-7 and demonstrated that maternal transferred NT antibodies against HHV-7 are maintained at much higher levels than those against HHV-6. These data are in accord with the results in paired sera obtained from mothers and cord blood specimens based on the IFA (15). These facts support the notion that infants after birth are protected from infection with these viruses by maternal transferred NT antibodies and acquire the primary infection after a decrease in these transferred NT antibodies.

ACKNOWLEDGMENTS
We thank T. Yamagata and colleagues for helpful support and
discussion.
Part of this work was supported by Grants-in-Aid for Scientific Research from the Ministry of Education, Culture, Science, and Technology of Japan.

FOOTNOTES
* Corresponding author. Mailing address: Department of Virology, Okayama University Graduate School of Medicine and Dentistry, 2-5-1 Shikatacho, Okayama 700-8558, Japan. Phone: 81-86-235-7167. Fax: 81-86-235-7169. E-mail:
mariko{at}md.okayama-u.ac.jp.


REFERENCES
1
- Ablashi, D. V., H. Agut, Z. Berneman, G. Campadelli-Fiume, D. Carrigan, L. Ceccerini-Nelli, B. Chandran, S. Chou, H. Collandre, R. Cone, T. Dambaugh, S. Dewhurst, D. Diluca, L. Foa-Tomasi, B. Fleckenstein, N. Frenkel, R. Gallo, U. Gompels, C. Hall, M. Jomes, G. Lawrence, M. Martin, L. Montagnier, F. Neipel, J. Nicholas, P. Pellet, A. Razzaque, G. Torrelli, B. Thomson, S. Salahuddin, L. Wyatt, and K. Yamanishi. 1993. Human herpesvirus-6 strain groups: a nomenclature. Arch. Virol. 129:363-366.[CrossRef][Medline]
2
- Ablashi, D. V., N. Balachandran, S. F. Josephs, C. L. Hung, G. R. Krueger, B. Kramarsky, S. Z. Salahuddin, and R. C. Gallo. 1991. Genomic polymorphism, growth properties, and immunologic variations in human herpesvirus-6 isolates. Virology 184:545-552.[CrossRef][Medline]
3
- Akashi, K., Y. Eizuru, Y. Sumiyoshi, T. Minematsu, S. Hara, M. Harada, M. Kikuchi, Y. Niho, and Y. Minamishima. 1993. Brief report: severe infectious mononucleosis-like syndrome and primary human herpesvirus 6 infection in an adult. N. Engl. J. Med. 329:168-171.[Free Full Text]
4
- Asano, Y., T. Yoshikawa, S. Suga, T. Yazaki, K. Kondo, and K. Yamanishi. 1990. Fatal fulminant hepatitis in an infant with human herpesvirus-6 infection. Lancet 335:862-863.[CrossRef][Medline]
5
- Black, J. B., N. Inoue, K. Kite-Powell, S. Zaki, and P. E. Pellett. 1993. Frequent isolation of human herpesvirus 7 from saliva. Virus Res. 29:91-98.[CrossRef][Medline]
6
- Buchwald, D., P. R. Cheney, D. L. Peterson, B. Henry, S. B. Wormsley, A. Geiger, D. V. Ablashi, S. Z. Salahuddin, C. Saxinger, R. Biddle, et al. 1992. A chronic illness characterized by fatigue, neurologic and immunologic disorders, and active human herpesvirus type 6 infection. Ann. Intern. Med. 116:103-113.
7
- Challoner, P. B., K. T. Smith, J. D. Parker, D. L. MacLeod, S. N. Coulter, T. M. Rose, E. R. Schultz, J. L. Bennett, R. L. Garber, M. Chang, P. A. Schad, P. M. Stewart, R. C. Nowinski, J. P. Brown, and G. C. Burmer. 1995. Plaque-associated expression of human herpesvirus 6 in multiple sclerosis. Proc. Natl. Acad. Sci. USA 92:7440-7444.[Abstract/Free Full Text]
8
- Descamps, V., F. Bouscarat, S. Laglenne, E. Aslangul, B. Veber, D. Descamps, J. L. Saraux, M. J. Grange, M. Grossin, E. Navratil, B. Crickx, and S. Belaich. 1997. Human herpesvirus 6 infection associated with anticonvulsant hypersensitivity syndrome and reactive haemophagocytic syndrome. Br. J. Dermatol. 137:605-608.[CrossRef][Medline]
9
- Frenkel, N., E. C. Schirmer, L. S. Wyatt, G. Katsafanas, E. Roffman, R. M. Danovich, and C. H. June. 1990. Isolation of a new herpesvirus from human CD4+ T cells. Proc. Natl. Acad. Sci. USA 87:748-752.[Abstract/Free Full Text]
10
- Fujiwara, N., H. Namba, R. Ohuchi, H. Isomura, F. Uno, M. Yoshida, S. Nii, and M. Yamada. 2000. Monitoring of human herpesvirus-6 and -7 genomes in saliva samples of healthy adults by competitive quantitative PCR. J. Med. Virol. 61:208-213.[CrossRef][Medline]
11
- Grose, C. 1996. Childhood infections with human herpesviruses types 6, 7, and 8. Adv. Pediatr. Infect. Dis. 12:181-208.
12
- Hidaka, Y., Y. Liu, M. Yamamoto, R. Mori, C. Miyazaki, K. Kusuhara, K. Okada, and K. Ueda. 1993. Frequent isolation of human herpesvirus 7 from saliva samples. J. Med. Virol. 40:343-346.[Medline]
13
- Levy, J. A. 1997. Three new human herpesviruses (HHV6, 7, and 8). Lancet 349:558-563.[CrossRef][Medline]
14
- Lusso, P., P. Secchiero, R. W. Crowley, A. Garzino-Demo, Z. N. Berneman, and R. C. Gallo. 1994. CD4 is a critical component of the receptor for human herpesvirus 7: interference with human immunodeficiency virus. Proc. Natl. Acad. Sci. USA 91:3872-3876.[Abstract/Free Full Text]
15
- Ohashi, M., M. Ihira, K. Suzuki, S. Suga, Y. Asano, T. Yoshikawa, Y. Saito, and H. Sakui. 2001. Transfer of human herpesvirus 6 and 7 antibodies from mothers to their offspring. Pediatr. Infect. Dis. J. 20:449-450.[CrossRef][Medline]
16
- Okuno, T., K. Higashi, K. Shiraki, K. Yamanishi, M. Takahashi, Y. Kokado, M. Ishibashi, S. Takahara, T. Sonoda, K. Tanaka, and et al. 1990. Human herpesvirus 6 infection in renal transplantation. Transplantation 49:519-522.[Medline]
17
- Pellet, P. E., and J. B. Black. 1996. Human herpesvirus 6, p. 2587-2608. In B. N. Field, D. M. Knipe, and P. M. Howley (ed.), Fields virology, 3rd ed., vol. 2. Lippincott-Raven Publishers, Philadelphia, Pa.
18
- Reed, L. J., and H. Muench. 1938. A simple method of estimating fifty percent endpoints. Am. J. Hyg 27:493-497.
19
- Salahuddin, S. Z., D. V. Ablashi, P. D. Markham, S. F. Josephs, S. Sturzenegger, M. Kaplan, G. Halligan, P. Biberfeld, F. Wong-Staal, B. Kramarsky, et al. 1986. Isolation of a new virus, HBLV, in patients with lymphoproliferative disorders. Science 234:596-601.[Abstract/Free Full Text]
20
- Santoro, F., P. E. Kennedy, G. Locatelli, M. S. Malnati, E. A. Berger, and P. Lusso. 1999. CD46 is a cellular receptor for human herpesvirus 6. Cell 99:817-827.
21
- Sullivan, J. R., and N. H. Shear. 2001. The drug hypersensitivity syndrome: what is the pathogenesis? Arch. Dermatol. 137:357-364.[Free Full Text]
22
- Suzuki, Y., R. Inagi, T. Aono, K. Yamanishi, and T. Shiohara. 1998. Human herpesvirus 6 infection as a risk factor for the development of severe drug-induced hypersensitivity syndrome. Arch. Dermatol. 134:1108-1112.[Abstract/Free Full Text]
23
- Takahashi, Y., M. Yamada, J. Nakamura, T. Tsukazaki, J. Padilla, T. Kitamura, M. Yoshida, and S. Nii. 1997. Transmission of human herpesvirus 7 through multigenerational families in the same household. Pediatr. Infect. Dis. J. 16:975-978.[CrossRef][Medline]
24
- Tanaka, K., T. Kondo, S. Torigoe, S. Okada, T. Mukai, and K. Yamanishi. 1994. Human herpesvirus 7: another causal agent for roseola (exanthem subitum). J. Pediatr. 125:1-5.[CrossRef][Medline]
25
- Tohyama, M., Y. Yahata, M. Yasukawa, R. Inagi, Y. Urano, K. Yamanishi, and K. Hashimoto. 1998. Severe hypersensitivity syndrome due to sulfasalazine associated with reactivation of human herpesvirus 6. Arch. Dermatol. 134:1113-1117.
26
- Tsukazaki, T., M. Yoshida, H. Namba, M. Yamada, N. Shimizu, and S. Nii. 1998. Development of a dot blot neutralizing assay for HHV-6 and HHV-7 using specific monoclonal antibodies. J. Virol. Methods 73:141-149.[CrossRef][Medline]
27
- Wyatt, L. S., and N. Frenkel. 1992. Human herpesvirus 7 is a constitutive inhabitant of adult human saliva. J. Virol. 66:3206-3209.[Abstract/Free Full Text]
28
- Yamada, M. 2001. Human herpesviruses 6 and 7: effects on hematopoiesis and mode of transmission. Jpn. J. Infect. Dis. 54:47-54.[Medline]
29
- Yamanishi, K., T. Okuno, K. Shiraki, M. Takahashi, T. Kondo, Y. Asano, and T. Kurata. 1988. Identification of human herpesvirus-6 as a causal agent for exanthem subitum. Lancet i:1065-1067.
30
- Yoshida, M., M. Yamada, S. Chatterjee, F. Lakeman, S. Nii, and R. J. Whitley. 1996. A method for detection of HHV-6 antigens and its use for evaluating antiviral drugs. J. Virol. Methods 58:137-143.[CrossRef][Medline]
31
- Yoshida, M., M. Yamada, T. Tsukazaki, S. Chatterjee, F. D. Lakeman, S. Nii, and R. J. Whitley. 1998. Comparison of antiviral compounds against human herpesvirus 6 and 7. Antivir. Res. 40:73-84.
32
- Yoshida, M., S. Torigoe, and M. Yamada. 2002. Elucidation of the cross-reactive immunoglobulin M response to human herpesviruses 6 and 7 on the basis of neutralizing antibodies. Clin. Diagn. Lab. Immunol. 9:394-402.
Clinical and Diagnostic Laboratory Immunology, March 2002, p. 388-393, Vol. 9, No. 2
1071-412X/02/$04.00+0 DOI: 10.1128/CDLI.9.2.388-393.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.
This article has been cited by other articles:
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