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OBJECTIVE To investigate the pathogenic role of human herpesvirus 6 (HHV-6) in idiopathic thrombocytopenic purpura (ITP). METHODS HHV-6 DNA was examined by polymerase chain reaction (PCR) in bone marrow mononuclear cells (BMMNC) of 105 ITP patients. Human cytomegalovirus (HCMV) and parvovirus B(19) DNA were also examined in some cases. Platelet-associated antibodies (PAIg) were measured by competitive ELISA in 66 ITP patients. Serum IgG titer to HHV-6 was observed by indirect immunofluorescence assay in 19 ITP patients. RESULTS (1) HHV-6 DNA positivity was 41.0% for ITP patients, significantly higher than that for control group (P < 0.05). HHV-6 DNA positivity for adult ITP patients, especially adult chronic cases was significantly higher than that for childhood patients (P < 0.025). Positivities for parvovirus B(19) and HCMV DNA were 24.1% and 9.7%, respectively. (2) HHV-6 DNA positivity for patients with abnormal level of PAIgG was significantly higher than that for patients with normal level of PAIgG (P < 0.05). (3) Patients coinfected with HHV-6 and B(19) or HCMV had more severe symptoms or poorer prognosis. CONCLUSIONS HHV-6 infection might be associated with excessive PAIgG. Coinfection with HHV-6, B(19) or HCMV may cause more severe symptoms in ITP patients.
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