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HelpTest ID: QHV6P Human Herpesvirus-6 A and B DNA Detection and Quantification, PCR, Plasma
Specimen Required
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube: Lavender top (EDTA)
Submission Container/Tube:
Preferred: Plastic vial
Acceptable: Screw-capped, sterile container
Specimen Volume: 1 mL
Collection Instructions: Centrifuge and aliquot plasma into a plastic vial.
Useful For
As an adjunct in the rapid diagnosis of human herpesvirus-6 infection using plasma specimens
This test should not be used to screen asymptomatic patients
Method Name
Real-Time Polymerase Chain Reaction (PCR)
Reporting Name
HHV-6 A and B DNA Quant PCR, PSpecimen Type
Plasma EDTASpecimen Minimum Volume
0.3 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Plasma EDTA | Refrigerated (preferred) | 7 days |
| Frozen | 7 days | |
| Ambient | 24 hours |
Clinical Information
Human herpesvirus-6 (HHV-6) is a member of the Herpesviridae family. These DNA viruses contain a capsid surrounded by a lipid envelope. Among members of this group, this virus is most closely related to cytomegalovirus (CMV) and HHV-7. As with other members of the herpesvirus group (herpes simplex virus [HSV]-1, HSV-2, varicella-zoster virus, CMV, Epstein-Barr virus, HHV-7, HHV-8), HHV-6 may cause primary and reactivated infections.(1) Infection with HHV-6 occurs early in childhood. Most adults (80%-90%) have been infected with this virus.
Human herpesvirus-6 was first linked with exanthem subitum (roseola infantum) in 1998; since then, the virus has been associated with central nervous system disease almost exclusively in patients who are immunocompromised.(1) HHV-6 is commonly detected in patients post transplantation. Clinical symptoms associated with this viral infection include febrile illness, pneumonitis, hepatitis, and encephalitis. However, most HHV-6 infections are asymptomatic.(2)
Human herpesvirus-6 is designated as variant A (HHV-6A) or variant B (HHV-6B) depending on restriction enzyme digestion patterns and its reaction with monoclonal antibodies. Generally, variant B has been associated with exanthem subitum, whereas variant A has been found in many immunosuppressed patients.(3) Infection with HHV-6 is very common, approaching 100% seroprevalence in developed countries.(4) In about 1% of the population, HHV-6 can integrate into the host genome. Often asymptomatic in immunocompetent hosts, reactivation can cause serious disease in immunocompromised individuals, particularly those with AIDS and transplant recipients, which can cause rejection of the transplanted organ and even death.(1)
This assay will be used to assist with diagnosis and monitoring of HHV-6 disease in patients who are suspected of having disease due to HHV-6 infection. It will also be used as an initial indicator of infection versus chromosomally-integrated HHV-6.
Reference Values
Undetected
Interpretation
The quantification range of this assay is 500 to 5,000,000 copies/mL (2.70 log to 6.70 log copies/mL)
An "Undetected" test result indicates the absence of human herpesvirus-6 (HHV-6) DNA in plasma.
A test result of "<500 copies/mL (<2.70 log copies/mL)" indicates that HHV-6 DNA is detected in the plasma, but the assay cannot accurately quantify the level of HHV-6 DNA.
A test result of ">5,000,000 copies/mL (>6.70 log copies/mL)" indicates that the HHV-6 DNA level present in plasma is above 5,000,000 copies/mL (6.70 log copies/mL), and the assay cannot accurately quantify the level of HHV-6 DNA. A viral load above 5,000,000 copies/mL should raise suspicion for chromosomally-integrated HHV-6 (ciHHV-6), and additional testing to rule out ciHHV-6 may be needed.
An "Inconclusive" result indicates that the presence or absence of HHV-6 DNA in the plasma specimen could not be determined with certainty after repeat testing in the laboratory, possibly due to inhibition or the presence of an interfering substance. If clinically indicated, submission of a new specimen for testing is recommended.
Clinical Reference
1. Agut H, Bonnafous P, Gautheret-Dejean A. Laboratory and clinical aspects of human herpesvirus 6 infections. Clin Microbiol Rev. 2015;28(2):313-335
2. De Bolle L, Naesens L, De Clercq E. Update on human herpesvirus 6 biology, clinical features, and therapy. Clin Microbiol Rev. 2005;18(1):217-245
3. Dockrell DH, Paya CV. Human herpesvirus-6 and -7 in transplantation. Rev Med Virol. 2001;11(1):23-36
4. Campadelli-Fiume G, Mirandola P, Menotti L. Human herpesvirus 6: An emerging pathogen. Emerging Infectious Diseases. 1999;5(3):353-366. doi:10.3201/eid0503.990306
5. Abdel-Haq NM, Asmar BI. Human herpesvirus 6 (HHV6) infection. Indian J Pediatr. 2004;71(1):89-96
6. Dockrell DH, Smith TF, Paya CV. Human herpesvirus 6. Mayo Clin Proc. 1999;74(2):163-170
7. Pellet Madan RP, Hand J; AST Infectious Diseases Community of Practice. Human herpesvirus 6, 7, and 8 in solid organ transplantation: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant, 2019;33(9):e13518. doi:10.1111/ctr.13518
8. Pawlowski AB, Karras NA, Liu H, et al. Reactivation of human herpesvirus 6 in pediatric allogeneic hematopoietic stem cell transplant recipients. Transpl Infect Dis. 2021;23(1):e13453. doi:10.1111/tid.13453
9. Yip CCY, Sridhar S, Cheng AKW, et al. Comparative evaluation of a laboratory developed real-time PCR assay and the RealStar HHV-6 PCR Kit for quantitative detection of human herpesvirus 6. J Virol Methods. 2017;246:112-116
Day(s) Performed
Monday through Friday
Report Available
4 to 6 daysTest Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
87533
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| QHV6P | HHV-6 A and B DNA Quant PCR, P | 49392-4 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 622169 | HHV6 A DNA Detect/Quant, P | 49392-4 |
| 622170 | HHV6 B DNA Detect/Quant, P | 49392-4 |
Forms
If not ordering electronically, complete, print, and send an Microbiology Test Request (T244) with the specimen.