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The present authors have recently reported that inoculation with human herpesvirus-6 (HHV-6) renders CD4 T lymphocytes susceptible to apoptosis in vitro. In order to confirm that apoptosis of CD4 T lymphocytes also occurs in HHV-6 infection in vivo, apoptosis of lymphocytes isolated from nine patients with exanthem subitum and from an adult patient with severe HHV-6 infection was examined. Peripheral blood mononuclear cells were cultured for 3 days and apoptosis of lymphocytes was then examined by flow cytometry of propidium iodide- stained DNA. The percentages of hypodiploid DNA, indicating apoptosis, in lymphocytes from 10 patients with HHV-6 infection were significantly higher than those from five infant patients with noninfectious diseases and five healthy adults (P < 0·0002). DNA fragmentation was also detected by agarose gel electrophoresis in lymphocytes from patients with HHV-6 infection. Apoptosis appeared to occur predominantly in CD4 T lymphocytes and HHV-6 was isolated from the CD4 T lymphocyte fraction. These data demonstrate that HHV-6 renders CD4 T lymphocytes susceptible to apoptosis in vivo.
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