Dual Antibody Rises to Cytomegalovirus and Human Herpesvirus Type 6: Frequency of Occurrence in CMV Infections and Evidence for Genuine Reactivity to Both Viruses

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Abstract
The frequency of high (>256) IgG anti-human herpesvirus type 6 (HHV-6) titers in sera known to be positive for IgM anti-cytomegalovirus (CMV) or IgM anti-Epstein Barr virus (EBV) was significantly greater than in sera from healthy controls or from a group of ill patients who were CMV and EBV IgM-negative (15/25 and 17/25 vs. 1/25 and 2/25, respectively, P < .001). There was serologic evidence of simultaneous HHV-6 infection or reactivation (a rise in IgG anti-HHV-6 titer or the presence of IgM anti-HHV-6) in sera from 14 of 17 primary CMV infections. In 5 of the 10 patients with concurrent rises in IgG titers to both viruses, the rise in IgG anti-HHV-6 preceded that of IgG anti-CMV. Complete removal of IgG anti-CMV reactivity from 5 sera from patients who had a primary CMV infection with a rise in IgG anti-HHV-6 titer had no effect on the IgG anti-HHV-6 titer of those sera, demonstrating that the rise in HHV-6 IgG titer was not a consequence of anti-CMV antibodies cross-reacting in the HHV-6 IgG assay.