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Congenital HHV-6 may negatively affect neurodevelopment
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Recent data show children with congenital human herpesvirus-6 had lower neurodevelopmental test scores compared with healthy children at age 1 year, suggesting the infection may have a negative effect on neurodevelopment.
Mary T. Caserta, MD, of the University of Rochester Medical Center in Rochester, N.Y., and colleagues assessed 39 infants with congenital human herpesvirus-6 (HHV-6) and 63 matched controls at ages 4 months, 6 months, 12 months and 24 months. Study participants completed the Fagan Test of Infant Intelligence, the Visual Expectation Paradigm and the Mental Development Index of the Bayley Scales of Infant Development II. Audiology screening and follow-up audiology examinations were conducted at age 12 to 24 months.
Mary T. Caserta
Children with congenital HHV-6 had a mean Mental Development Index score of 103.4 at age 12 months, compared with 105.4 among children in the control.
One control infant had a Bayley Mental Development Index score of 61, more than 3 standard-deviations below the mean score. Analysis removing this value indicated Bayley Mental Development Index scores among infants with congenital HHV-6 had a mean difference of 4.1 (95% CI, 0.3-7.9; P=.03) compared with controls.
Bayley Mental Development Index scores were significantly associated with greater gestational age at birth (3.1; P<.01) and breast-feeding status at age 6 months (4.6; P=.02).
Bayley Mental Development Index scores were significantly lower among children with chromosomal integration of HHV-6 compared with controls, with a mean difference of 4.1 (95% CI, 0.0-8.2; P=.05).
Children with transplacental infection were not significantly different from controls regarding Bayley Mental Development Index scores.
Fagan Test of Infant Intelligence results did not differ between children with and without congenital HHV-6 for novelty preference, mean fixation duration for familiarization trials or mean fixation duration for novelty preference trials. However, when controlling for age, gender, gestational age and mother’s Kaufman Brief Intelligence Test, mean fixation duration declined with age for familiarization trials (-0.82; 95% CI, –1.16 to –0.48) and novelty preference trials (-0.56; 95% CI, –0.87 to –0.25).
Analysis of Visual Expectation Paradigm results indicated a decline in saccade reaction time with postnatal age (-2.72; 95% CI, –4.08 to –1.36). In unadjusted and adjusted models, reaction time did not differ regarding congenital HHV-6 status (P=.82). Age by congenital HHV-6 infection status did not affect results, according to researchers.
No study participants had hearing loss identified by newborn screening or follow-up screening at age 12 to 24 months.
“Our data suggest that congenital HHV-6 infection may be associated with cognitive impairment at 12 months of age as noted on the Bayley- Mental Development Index, with a magnitude similar in effect to well-known environmental toxins,” the researchers wrote. “Because congenital infection with HHV-6 is present in about 1 in every 101 births, further study of the neurodevelopmental effects of HHV-6 congenital infection during infancy and later childhood are warranted.”
Disclosure: The researchers report no relevant financial disclosures.
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