{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T15:15:18Z","timestamp":1770822918932,"version":"3.50.1"},"reference-count":60,"publisher":"Archives of Pathology and Laboratory Medicine","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2000,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Objectives.<\/jats:italic>\n                    \u2014To determine the proportion of patients with evidence of an acute infection due to Epstein-Barr virus (EBV), cytomegalovirus (CMV), human herpesvirus 6 (HHV-6),\n                    <jats:italic>Toxoplasma,<\/jats:italic>\n                    or human immunodeficiency virus types 1 and 2 (HIV-1 and HIV-2) in heterophile-negative patients with an absolute lymphocytosis or an instrument-generated atypical lymphocyte flag, and to develop a cost-effective testing algorithm for managing such heterophile-negative patients.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Design.<\/jats:italic>\n                    \u2014We conducted a prospective investigation of 70 selected outpatients who tested negative for heterophile antibody in association with an absolute lymphocytosis or instrument-generated atypical lymphocyte flag. The control population consisted of 50 patients who were heterophile negative and had a normal absolute lymphocyte count and no instrument-generated atypical lymphocyte flag.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Setting.<\/jats:italic>\n                    \u2014A large outpatient laboratory system.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Intervention.<\/jats:italic>\n                    \u2014Viral serology for HHV-6 was performed by immunofluorescence, and all other serologies were performed by enzyme-linked immunoassay. All testing was for immunoglobulin (Ig) M antibodies, except in the case of HIV.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Results.<\/jats:italic>\n                    \u2014The proportion of study patients positive for EBV was 40% (28\/70); for CMV, 39% (27\/70); for HHV-6, 25% (16\/65); for\n                    <jats:italic>Toxoplasma,<\/jats:italic>\n                    3% (2\/70); and for HIV, 0% (0\/70). All 50 control patients were negative for EBV IgM antibodies. When patients with more than 1 positive viral test were excluded from analysis, positivity was 20% (9\/45) for EBV, 22% (10\/45) for CMV, 9% (4\/45) for HHV-6, and 2% (1\/45) for\n                    <jats:italic>Toxoplasma.<\/jats:italic>\n                    Utilizing hypothesis-generating logistic regression models, Downey type II atypical lymphocytes were significantly associated with EBV positivity (\n                    <jats:italic>P<\/jats:italic>\n                    = .006), while Downey type III lymphocytes were significantly associated with HHV-6 positivity (\n                    <jats:italic>P<\/jats:italic>\n                    = .016), and there was a trend for the association of Downey type I lymphocytes with CMV positivity (\n                    <jats:italic>P<\/jats:italic>\n                    = .097).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusions.<\/jats:italic>\n                    \u2014A positive viral serology was identified in 70% of study patients. Multiple positive serologies complicate establishing a definitive diagnosis. Potential cost savings may be associated with the use of an appropriate testing algorithm.\n                  <\/jats:p>","DOI":"10.5858\/2000-124-1324-ppfebv","type":"journal-article","created":{"date-parts":[[2021,1,28]],"date-time":"2021-01-28T21:44:59Z","timestamp":1611870299000},"page":"1324-1330","source":"Crossref","is-referenced-by-count":20,"title":["Proportion Positive for Epstein-Barr Virus, Cytomegalovirus, Human Herpesvirus 6, Toxoplasma, and Human Immunodeficiency Virus Types 1 and 2 in Heterophile-Negative Patients With an Absolute Lymphocytosis or an Instrument-Generated Atypical Lymphocyte Flag"],"prefix":"10.5858","volume":"124","author":[{"given":"Yotis F.","family":"Tsaparas","sequence":"first","affiliation":[{"name":"From the University of Calgary Medical School, Calgary, Alberta, Canada (Mr Tsaparas); Department of Medical Oncology, BC Cancer Agency\u2013Center for the Southern Interior, Kelowna, British Columbia, Canada (Dr Brigden); and the Departments of Health Care and Epidemiology (Drs Mathias and Raboud) and Pathology and Laboratory Medicine (Drs Thomas and Doyle), University of British Columbia, Vancouver, British Columbia, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malcolm L.","family":"Brigden","sequence":"additional","affiliation":[{"name":"From the University of Calgary Medical School, Calgary, Alberta, Canada (Mr Tsaparas); Department of Medical Oncology, BC Cancer Agency\u2013Center for the Southern Interior, Kelowna, British Columbia, Canada (Dr Brigden); and the Departments of Health Care and Epidemiology (Drs Mathias and Raboud) and Pathology and Laboratory Medicine (Drs Thomas and Doyle), University of British Columbia, Vancouver, British Columbia, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Mathias","sequence":"additional","affiliation":[{"name":"From the University of Calgary Medical School, Calgary, Alberta, Canada (Mr Tsaparas); Department of Medical Oncology, BC Cancer Agency\u2013Center for the Southern Interior, Kelowna, British Columbia, Canada (Dr Brigden); and the Departments of Health Care and Epidemiology (Drs Mathias and Raboud) and Pathology and Laboratory Medicine (Drs Thomas and Doyle), University of British Columbia, Vancouver, British Columbia, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"Thomas","sequence":"additional","affiliation":[{"name":"From the University of Calgary Medical School, Calgary, Alberta, Canada (Mr Tsaparas); Department of Medical Oncology, BC Cancer Agency\u2013Center for the Southern Interior, Kelowna, British Columbia, Canada (Dr Brigden); and the Departments of Health Care and Epidemiology (Drs Mathias and Raboud) and Pathology and Laboratory Medicine (Drs Thomas and Doyle), University of British Columbia, Vancouver, British Columbia, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janet","family":"Raboud","sequence":"additional","affiliation":[{"name":"From the University of Calgary Medical School, Calgary, Alberta, Canada (Mr Tsaparas); Department of Medical Oncology, BC Cancer Agency\u2013Center for the Southern Interior, Kelowna, British Columbia, Canada (Dr Brigden); and the Departments of Health Care and Epidemiology (Drs Mathias and Raboud) and Pathology and Laboratory Medicine (Drs Thomas and Doyle), University of British Columbia, Vancouver, British Columbia, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick W.","family":"Doyle","sequence":"additional","affiliation":[{"name":"Reprints: Patrick W. Doyle, MD, Canadian Blood Services, 4750 Oak St, Vancouver, BC, Canada V6H 2N9."},{"name":"From the University of Calgary Medical School, Calgary, Alberta, Canada (Mr Tsaparas); Department of Medical Oncology, BC Cancer Agency\u2013Center for the Southern Interior, Kelowna, British Columbia, Canada (Dr Brigden); and the Departments of Health Care and Epidemiology (Drs Mathias and Raboud) and Pathology and Laboratory Medicine (Drs Thomas and Doyle), University of British Columbia, Vancouver, British Columbia, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3906","reference":[{"key":"i1543-2165-124-9-1324-b1","series-title":"Ann Intern Med","first-page":"505","article-title":"Heterophil antibody in adults with sore throat.","volume":"94","author":"Aronson, M. D.","year":"1982","unstructured":"Aronson, M. D., A. L.Komaroff, T. M.Pass, C. T.Ervin, and W. T.Branch. Heterophil antibody in adults with sore throat.Ann Intern Med1982. 94:505\u2013508."},{"key":"i1543-2165-124-9-1324-b2","series-title":"Am J Med","first-page":"947","article-title":"Heterophil-negative infectious mononucleosis and mononucleosis-like illnesses.","volume":"63","author":"Horwitz, C. A.","year":"1977","unstructured":"Horwitz, C. A., W.Henle, and G.Henle. et al. Heterophil-negative infectious mononucleosis and mononucleosis-like illnesses.Am J Med1977. 63:947\u2013957."},{"key":"i1543-2165-124-9-1324-b3","series-title":"Proc Natl Acad Sci U S A","first-page":"748","article-title":"Isolation of a new herpesvirus from CD4+ T cells.","volume":"87","author":"Frenkel, N.","year":"1990","unstructured":"Frenkel, N., E. C.Schimer, and L. S.Wyatt. et al. Isolation of a new herpesvirus from CD4+ T cells.Proc Natl Acad Sci U S A1990. 87:748\u2013752."},{"key":"i1543-2165-124-9-1324-b4","series-title":"Primary Care","first-page":"295","article-title":"Infectious mononucleosis.","volume":"2","author":"Hoagland, R. J.","year":"1975","unstructured":"Hoagland, R. J.\n          \n          Infectious mononucleosis.\n          Primary Care\n          1975. 2:295\u2013307."},{"key":"i1543-2165-124-9-1324-b5","series-title":"Am J Med","first-page":"923","article-title":"The atypical lymphocyte.","volume":"42","author":"Wood, T. A.","year":"1967","unstructured":"Wood, T. A. and E. P.Frenkel. The atypical lymphocyte.Am J Med1967. 42:923\u2013936."},{"key":"i1543-2165-124-9-1324-b6","series-title":"Acta Med Scand Suppl","first-page":"1","article-title":"Infectious mononucleosis: a clinical and haematological study of patients and contact, and a comparison with healthy subjects.","volume":"413","author":"Pejme, J.","year":"1964","unstructured":"Pejme, J.\n          \n          Infectious mononucleosis: a clinical and haematological study of patients and contact, and a comparison with healthy subjects.\n          Acta Med Scand Suppl\n          1964. 413:1\u201383."},{"key":"i1543-2165-124-9-1324-b7","first-page":"159","article-title":"HHV-6-induced mononucleosis-like illnesses.","author":"Horwitz, C. A.","year":"1992","unstructured":"Horwitz, C. A., G. R. F.Krueger, T. A.Steeper, and G.Bertram. HHV-6-induced mononucleosis-like illnesses.In: Ablashi DV, Krueger GRF, Salahuddin SZ, eds. Human Herpesvirus-6: Epidemiology, Molecular Biology, and Clinical Pathology. Amsterdam, Holland: Elsevier Science Publishers. 1992. 159\u2013174."},{"key":"i1543-2165-124-9-1324-b8","series-title":"Am J Clin Pathol","first-page":"776","article-title":"The spectrum of clinical and laboratory findings resulting from human herpesvirus-6 (hhv-6) in patients with mononucleosis-like illnesses not resulting from Epstein-Barr virus or cytomegalovirus.","volume":"93","author":"Steeper, T. A.","year":"1990","unstructured":"Steeper, T. A., C. A.Horwitz, and D. V.Ablashi. et al. The spectrum of clinical and laboratory findings resulting from human herpesvirus-6 (hhv-6) in patients with mononucleosis-like illnesses not resulting from Epstein-Barr virus or cytomegalovirus.Am J Clin Pathol1990. 93:776\u2013783."},{"key":"i1543-2165-124-9-1324-b9","first-page":"47","article-title":"Laboratory findings in infectious mononucleosis.","author":"Finch, S. C.","year":"1969","unstructured":"Finch, S. C.\n          \n          Laboratory findings in infectious mononucleosis.\n          In: Carter RL, Penman HG, eds. Infectious Mononucleosis. Oxford, England: Blackwell. 1969. 47."},{"key":"i1543-2165-124-9-1324-b10","series-title":"J Clin Microbiol","first-page":"619","article-title":"Limitations of available tests for diagnosis of infectious mononucleosis.","volume":"17","author":"Fleisher, G. R.","year":"1983","unstructured":"Fleisher, G. R., M.Collins, and S.Fager. Limitations of available tests for diagnosis of infectious mononucleosis.J Clin Microbiol1983. 17:619\u2013624."},{"key":"i1543-2165-124-9-1324-b11","series-title":"BMJ","first-page":"156","article-title":"Serological diagnosis of infection with human herpesvirus-6.","volume":"300","author":"Irving, W. L.","year":"1990","unstructured":"Irving, W. L. and A. L.Cunningham. Serological diagnosis of infection with human herpesvirus-6.BMJ1990. 300:156\u2013159."},{"key":"i1543-2165-124-9-1324-b12","first-page":"121","article-title":"Interactions between HHV-6 and other viruses.","author":"Lusso, P.","year":"1992","unstructured":"Lusso, P., D. V.Ablashi, and J.Luka. Interactions between HHV-6 and other viruses.In: Ablashi D, Krueger GRF, Salahuddin SZ, eds. Human Herpesvirus-6: Epidemiology, Molecular Biology, and Clinical Pathology: Perspectives in Medical Virology. Vol 4. Amsterdam, Holland: Elsevier Science Publishers. 1992. 121\u2013133."},{"key":"i1543-2165-124-9-1324-b13","series-title":"J Infect Dis","first-page":"567","article-title":"Lack of correlation between human herpesvirus-6 infection and the course of human immunodeficiency virus infection.","volume":"161","author":"Spira, T. J.","year":"1990","unstructured":"Spira, T. J., L. H.Bozeman, and K. C.Sanderlin. et al. Lack of correlation between human herpesvirus-6 infection and the course of human immunodeficiency virus infection.J Infect Dis1990. 161:567\u2013570."},{"key":"i1543-2165-124-9-1324-b14","series-title":"J Infect Dis","first-page":"844","article-title":"Suppression of human immunodeficiency virus type I replication by human herpesvirus-6.","volume":"162","author":"Carrigan, D. R.","year":"1990","unstructured":"Carrigan, D. R., K. K.Knox, and M. A.Tapper. Suppression of human immunodeficiency virus type I replication by human herpesvirus-6.J Infect Dis1990. 162:844\u2013851."},{"key":"i1543-2165-124-9-1324-b15","series-title":"J Clin Microbiol","first-page":"2362","article-title":"Human herpesvirus 6 inhibits human immunodeficiency virus type 1 replication in cell culture.","volume":"28","author":"Levy, J.","year":"1990","unstructured":"Levy, J., A.Landay, and E.Lennette. Human herpesvirus 6 inhibits human immunodeficiency virus type 1 replication in cell culture.J Clin Microbiol1990. 28:2362\u20132364."},{"key":"i1543-2165-124-9-1324-b16","series-title":"Am J Clin Pathol","first-page":"169","article-title":"Heterophil-negative mononucleosis-like illnesses with atypical lymphocytosis in patients undergoing seroconversions to the human immunodeficiency virus.","volume":"90","author":"Steeper, T. A.","year":"1988","unstructured":"Steeper, T. A., C. A.Horwitz, and M.Hanson. et al. Heterophil-negative mononucleosis-like illnesses with atypical lymphocytosis in patients undergoing seroconversions to the human immunodeficiency virus.Am J Clin Pathol1988. 90:169\u2013174."},{"key":"i1543-2165-124-9-1324-b17","series-title":"West J Med","first-page":"445","article-title":"Infectious mononucleosis and mononucleosis syndromes.","volume":"126","author":"Fiala, M.","year":"1977","unstructured":"Fiala, M., D. C.Heiner, J. A.Turner, B.Rosenbloom, and L. B.Guze. Infectious mononucleosis and mononucleosis syndromes.West J Med1977. 126:445\u2013459."},{"key":"i1543-2165-124-9-1324-b18","series-title":"Epidemiol Infect","first-page":"289","article-title":"Production of IgM antibody to HHV6 in reactivation and primary infection.","volume":"104","author":"Fox, J. D.","year":"1990","unstructured":"Fox, J. D., P.Ward, M.Briggs, W.Irving, and T. G.Stammers. Production of IgM antibody to HHV6 in reactivation and primary infection.Epidemiol Infect1990. 104:289\u2013296."},{"key":"i1543-2165-124-9-1324-b19","series-title":"J Virol","first-page":"5975","article-title":"Determination and analysis of the complete nucleotide sequence of human herpesvirus-7.","volume":"70","author":"Nicholas, J.","year":"1996","unstructured":"Nicholas, J.\n          \n          Determination and analysis of the complete nucleotide sequence of human herpesvirus-7.\n          J Virol\n          1996. 70:5975\u20135989."},{"key":"i1543-2165-124-9-1324-b20","series-title":"Proc Natl Acad Sci U S A","first-page":"10552","article-title":"Human herpesvirus-7 is a T-lymphotropic virus and is related to, but significantly different from, human herpesvirus 6 and human cytomegalovirus.","volume":"89","author":"Berneman, Z. N.","year":"1992","unstructured":"Berneman, Z. N., D. V.Ablashi, and G.Li. et al. Human herpesvirus-7 is a T-lymphotropic virus and is related to, but significantly different from, human herpesvirus 6 and human cytomegalovirus.Proc Natl Acad Sci U S A1992. 89:10552\u201310556."},{"key":"i1543-2165-124-9-1324-b21","series-title":"Adv Virus Res","first-page":"1","article-title":"Human herpesvirus 6: the virus and the search for its role as a human pathogen.","volume":"41","author":"Pellet, P. E.","year":"1992","unstructured":"Pellet, P. E., J. B.Black, and M.Yamamoto. Human herpesvirus 6: the virus and the search for its role as a human pathogen.Adv Virus Res1992. 41:1\u201352."},{"key":"i1543-2165-124-9-1324-b22","series-title":"Ann Int Med","first-page":"45","article-title":"Epstein-Barr virus infections: biology, pathogenesis, and management.","volume":"118","author":"Straus, S. E.","year":"1993","unstructured":"Straus, S. E.\n          \n          Epstein-Barr virus infections: biology, pathogenesis, and management.\n          Ann Int Med\n          1993. 118:45\u201358."},{"key":"i1543-2165-124-9-1324-b23","series-title":"Leukemia","first-page":"465","article-title":"Transformation of large granular lymphocytic leukemia during the course of a reactivated human herpesvirus-6 infection.","volume":"6","author":"Tagawa, S.","year":"1992","unstructured":"Tagawa, S., M.Mizuki, and U.Onoi. et al. Transformation of large granular lymphocytic leukemia during the course of a reactivated human herpesvirus-6 infection.Leukemia1992. 6:465\u2013469."},{"key":"i1543-2165-124-9-1324-b24","first-page":"9","article-title":"The epidemiology of human herpesvirus-6.","author":"Levine, P. H.","year":"1992","unstructured":"Levine, P. H., R.Jarrett, and D. A.Clark. The epidemiology of human herpesvirus-6.In: Ablashi DV, Krueger GRF, Salahuddin SZ, eds. Human Herpesvirus-6: Epidemiology, Molecular Biology, and Clinical Pathology. Amsterdam, Holland: Elsevier Science Publishers. 1992. 9\u201323."},{"key":"i1543-2165-124-9-1324-b25","series-title":"Am Fam Physician","first-page":"1599","article-title":"Infectious mononucleosis in older adults.","volume":"42","author":"Axelrod, P.","year":"1990","unstructured":"Axelrod, P. and A. J.Finestone. Infectious mononucleosis in older adults.Am Fam Physician1990. 42:1599\u20131606."},{"key":"i1543-2165-124-9-1324-b26","series-title":"Infect Med","first-page":"192","article-title":"HHV-6 infection in immunocompromised patients.","volume":"15","author":"Secchiero, P.","year":"1998","unstructured":"Secchiero, P. and F. R.Cleghorn. 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Infectious-mononucleosis-like disease with negative heterophil agglutination test: clinical features in relation to Epstein-Barr virus and cytomegalovirus antibodies.J Infect Dis1970. 121:608\u2013614."},{"key":"i1543-2165-124-9-1324-b29","series-title":"Can J Infect Dis","first-page":"185","article-title":"Disease association and diagnosis of human herpesvirus 6.","volume":"5","author":"Weber, J. M.","year":"1994","unstructured":"Weber, J. M. and G.Wilson. Disease association and diagnosis of human herpesvirus 6.Can J Infect Dis1994. 5:185\u2013185."},{"key":"i1543-2165-124-9-1324-b30","series-title":"Br Med J","first-page":"1099","article-title":"Cytomegalovirus as a possible cause of a disease resembling infectious mononucleosis.","volume":"2","author":"Klemola, E.","year":"1965","unstructured":"Klemola, E. and L.Kaariainen. 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Heterophil-negative infectious mononucleosis and mononucleosis-like illnesses.Am J Med1977. 63:947\u2013957."},{"key":"i1543-2165-124-9-1324-b3","series-title":"Proc Natl Acad Sci U S A","first-page":"748","article-title":"Isolation of a new herpesvirus from CD4+ T cells.","volume":"87","author":"Frenkel, N.","year":"1990","unstructured":"Frenkel, N., E. C.Schimer, and L. S.Wyatt. et al. Isolation of a new herpesvirus from CD4+ T cells.Proc Natl Acad Sci U S A1990. 87:748\u2013752."},{"key":"i1543-2165-124-9-1324-b4","series-title":"Primary Care","first-page":"295","article-title":"Infectious mononucleosis.","volume":"2","author":"Hoagland, R. J.","year":"1975","unstructured":"Hoagland, R. J.\n          \n          Infectious mononucleosis.\n          Primary Care\n          1975. 2:295\u2013307."},{"key":"i1543-2165-124-9-1324-b5","series-title":"Am J Med","first-page":"923","article-title":"The atypical lymphocyte.","volume":"42","author":"Wood, T. A.","year":"1967","unstructured":"Wood, T. A. and E. P.Frenkel. The atypical lymphocyte.Am J Med1967. 42:923\u2013936."},{"key":"i1543-2165-124-9-1324-b6","series-title":"Acta Med Scand Suppl","first-page":"1","article-title":"Infectious mononucleosis: a clinical and haematological study of patients and contact, and a comparison with healthy subjects.","volume":"413","author":"Pejme, J.","year":"1964","unstructured":"Pejme, J.\n          \n          Infectious mononucleosis: a clinical and haematological study of patients and contact, and a comparison with healthy subjects.\n          Acta Med Scand Suppl\n          1964. 413:1\u201383."},{"key":"i1543-2165-124-9-1324-b7","first-page":"159","article-title":"HHV-6-induced mononucleosis-like illnesses.","author":"Horwitz, C. A.","year":"1992","unstructured":"Horwitz, C. A., G. R. F.Krueger, T. A.Steeper, and G.Bertram. HHV-6-induced mononucleosis-like illnesses.In: Ablashi DV, Krueger GRF, Salahuddin SZ, eds. 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C.\n          \n          Laboratory findings in infectious mononucleosis.\n          In: Carter RL, Penman HG, eds. Infectious Mononucleosis. Oxford, England: Blackwell. 1969. 47."},{"key":"i1543-2165-124-9-1324-b10","series-title":"J Clin Microbiol","first-page":"619","article-title":"Limitations of available tests for diagnosis of infectious mononucleosis.","volume":"17","author":"Fleisher, G. R.","year":"1983","unstructured":"Fleisher, G. R., M.Collins, and S.Fager. Limitations of available tests for diagnosis of infectious mononucleosis.J Clin Microbiol1983. 17:619\u2013624."},{"key":"i1543-2165-124-9-1324-b11","series-title":"BMJ","first-page":"156","article-title":"Serological diagnosis of infection with human herpesvirus-6.","volume":"300","author":"Irving, W. L.","year":"1990","unstructured":"Irving, W. L. and A. L.Cunningham. Serological diagnosis of infection with human herpesvirus-6.BMJ1990. 300:156\u2013159."},{"key":"i1543-2165-124-9-1324-b12","first-page":"121","article-title":"Interactions between HHV-6 and other viruses.","author":"Lusso, P.","year":"1992","unstructured":"Lusso, P., D. V.Ablashi, and J.Luka. Interactions between HHV-6 and other viruses.In: Ablashi D, Krueger GRF, Salahuddin SZ, eds. Human Herpesvirus-6: Epidemiology, Molecular Biology, and Clinical Pathology: Perspectives in Medical Virology. Vol 4. Amsterdam, Holland: Elsevier Science Publishers. 1992. 121\u2013133."},{"key":"i1543-2165-124-9-1324-b13","series-title":"J Infect Dis","first-page":"567","article-title":"Lack of correlation between human herpesvirus-6 infection and the course of human immunodeficiency virus infection.","volume":"161","author":"Spira, T. J.","year":"1990","unstructured":"Spira, T. J., L. H.Bozeman, and K. C.Sanderlin. et al. Lack of correlation between human herpesvirus-6 infection and the course of human immunodeficiency virus infection.J Infect Dis1990. 161:567\u2013570."},{"key":"i1543-2165-124-9-1324-b14","series-title":"J Infect Dis","first-page":"844","article-title":"Suppression of human immunodeficiency virus type I replication by human herpesvirus-6.","volume":"162","author":"Carrigan, D. R.","year":"1990","unstructured":"Carrigan, D. R., K. K.Knox, and M. A.Tapper. Suppression of human immunodeficiency virus type I replication by human herpesvirus-6.J Infect Dis1990. 162:844\u2013851."},{"key":"i1543-2165-124-9-1324-b15","series-title":"J Clin Microbiol","first-page":"2362","article-title":"Human herpesvirus 6 inhibits human immunodeficiency virus type 1 replication in cell culture.","volume":"28","author":"Levy, J.","year":"1990","unstructured":"Levy, J., A.Landay, and E.Lennette. 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