Assay | Advantages | Disadvantages |
Culture | ||
Positive results represent active infection or replication Able to distinguish between HHV-6A and HHV-6B variants | Technically difficult Long turn-around time | |
PCR | ||
DNA PCR | ||
Plasma | Correlates well with diagnostic and clinical indicators of primary infection and with virus isolation after transplantation Able to distinguish between HHV-6A and HHV-6B variants | |
PBMC | Able to distinguish between HHV-6A and HHV-6B variants | Requires quantitative cut-offs for established sensitivity threshold in order to distinguish latent from active infection Negative results may be difficult to interpret in lymphopenic patients (eg, HCT recipients early after transplantation) |
CSF | Able to distinguish between HHV-6A and HHV-6B variants | |
Reverse transcription PCR | ||
Positive results represent active infection or replication | ||
Serology | ||
Conventional | ||
Does not reliably distinguish between active and latent infection There may be interference from maternal antibodies around the time of primary infection Immunocompromised patients do not reliably mount an antibody response Unable to distinguish between HHV-6A and HHV-6B variants | ||
Avidity assays | ||
Able to distinguish between antibody associated with primary versus established infection | Unable to distinguish between reactivation and latent infection Unable to distinguish between HHV-6A and HHV-6B variants |
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