Children infected by human herpesvirus 6B with febrile seizures are more likely to develop febrile status epilepticus: A case-control study in a referral hospital in Zambia

J Med Virol. 2018 Nov;90(11):1757-1764. doi: 10.1002/jmv.25269. Epub 2018 Aug 13.


Background: Human herpesvirus 6B (HHV-6B) is the causative agent of Roseola infantum, and has also been suggested to play a role in the pathogenesis of febrile seizures in young children, a percentage of whom go on to develop febrile status epilepticus (FSE), but the existing data is conflicting and inconclusive. HHV-6A is a distinct species, rarely detected in most parts of the world, but prior studies suggest a higher prevalence in febrile African children. We describe a case-control study comparing the frequency of HHV-6A and/or HHV-6B infections in children with febrile seizures (including FSE) and a control group of febrile children without seizures.

Methods: We recruited children aged 6 to 60 months admitted with a febrile illness with (cases) or without (controls) seizures presenting within 48 hours of commencement of fever. Three milliliters of whole blood was centrifuged and plasma stored at -80°C for pooled screening for HHV-6B and HHV-6A by Taqman real-time polymerase chain reaction.

Results: 102 cases and 95 controls were recruited. The prevalence of HHV-6B DNA detection did not differ significantly between cases (5.8% (6/102)) and controls (10.5% (10/95)) but HHV-6B infection was associated with FSE (OR, 15; 95% CI, [1.99-120]; P= 0.009). HHV-6A was not detected.

Conclusion: Prevalence of HHV-6B was similar among cases and controls. Within the FS group, HHV-6B infection was associated with FSE, suggesting HHV-6B infections could play a role in the pathogenesis of FSE.

Keywords: case control; febrile seizures; febrile status epilepticus; human herpesvirus 6A (HHV-6A); human herpesvirus 6B (HHV-6B).

MeSH terms

  • Case-Control Studies
  • Child, Preschool
  • Exanthema Subitum / complications*
  • Exanthema Subitum / pathology*
  • Exanthema Subitum / virology
  • Female
  • Herpesvirus 6, Human / genetics
  • Herpesvirus 6, Human / isolation & purification*
  • Hospitals
  • Humans
  • Infant
  • Male
  • Prevalence
  • Real-Time Polymerase Chain Reaction
  • Seizures, Febrile / epidemiology*
  • Status Epilepticus / epidemiology*
  • Zambia / epidemiology