Human herpesvirus 6

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Human herpesvirus 6 (HHV-6) is a set of two closely related herpesviruses, HHV6-A and HHV6-B. Infection is extremely common and usually occurs at an early age. 64-83% of infants are infected by age 13 months.[1] HHV-6 has an affinity for leukocytes and nervous tissue, especially the olfactory bulb tissues[2], from which it is thought to disseminate to other parts of the brain. After infection the virus remains latent but can reactivate asymptomatically even in healthy individuals.

HHV-6 has been found to activate Epstein-Barr virus from latency. Conversely, the presence of EBV renders B cells more susceptible to HHV-6 infection.[3]

In human disease[edit | edit source]

HHV-6 has been implicated as a contributing factor to a number of neurological diseases including multiple sclerosis[4], chronic fatigue syndrome[5] and epilepsy, as well as fibromyalgia and AIDS.

Multiple sclerosis[edit | edit source]

HHV-6 has been found in the oligodendrocytes of plaques in MS patients but not in healthy tissue.[6]

Antivirals may have some therapeutic benefit. A randomized, placebo-controlled double-blind study found that acyclovir reduced the exacerbation rate in relapsing-remitting MS patients.[7]. Valacyclovir reduced new lesions in patients with high disease activity.[8]

Cancer[edit | edit source]

Like Epstein-Barr virus, HHV-6 is associated with lymphomas and carcinomas.[3]

Chronic fatigue syndrome[edit | edit source]

One study found a higher prevalence of past HHV-6 infection in chronic fatigue syndrome patients but with a low viral load that did not suggest reactivation.[9] Several studies have found that active infection is more common in CFS patients than healthy controls.[5]

Antivirals[edit | edit source]

There is no drug approved for treating HHV-6.[10] Those used clinically are the drugs used for human cytomegalovirus: ganciclovir (Cytovene IV), cidofovir (Vistide IV), and foscarnet (Foscavir IV).[10][11]

Notable studies[edit | edit source]

Learn more[edit | edit source]

See also[edit | edit source]

References[edit | edit source]

  1. Braun, D. K.; Dominguez, G.; Pellett, P. E. (Jul 1997). "Human herpesvirus 6". Clinical Microbiology Reviews. 10 (3): 521–567. ISSN 0893-8512. PMID 9227865. 
  2. Harberts, Erin; Yao, Karen; Wohler, Jillian E.; Maric, Dragan; Ohayon, Joan; Henkin, Robert; Jacobson, Steven (Aug 16, 2011). "Human herpesvirus-6 entry into the central nervous system through the olfactory pathway". Proceedings of the National Academy of Sciences of the United States of America. 108 (33): 13734–13739. doi:10.1073/pnas.1105143108. ISSN 1091-6490. PMC 3158203Freely accessible. PMID 21825120. 
  3. 3.03.1 De Bolle, Leen; Naesens, Lieve; De Clercq, Erik (Jan 2005). "Update on Human Herpesvirus 6 Biology, Clinical Features, and Therapy". Clinical Microbiology Reviews. 18 (1): 217–245. doi:10.1128/CMR.18.1.217-245.2005. ISSN 0893-8512. PMID 15653828. 
  4. Pietiläinen-Nicklén, Jenna; Virtanen, Jussi O.; Uotila, Lasse; Salonen, Oili; Färkkilä, Markus; Koskiniemi, Marjaleena (Oct 2014). "HHV-6-positivity in diseases with demyelination". Journal of Clinical Virology. 61 (2): 216–219. doi:10.1016/j.jcv.2014.07.006. ISSN 1873-5967. PMID 25088617. 
  5. 5.05.1 Komaroff, Anthony L. (Dec 2006). "Is human herpesvirus-6 a trigger for chronic fatigue syndrome?". Journal of Clinical Virology: The Official Publication of the Pan American Society for Clinical Virology. 37 Suppl 1: S39–46. doi:10.1016/S1386-6532(06)70010-5. ISSN 1386-6532. PMID 17276367. 
  6. Challoner, P. B.; Smith, K. T.; Parker, J. D.; MacLeod, D. L.; Coulter, S. N.; Rose, T. M.; Schultz, E. R.; Bennett, J. L.; Garber, R. L. (Aug 1, 1995). "Plaque-associated expression of human herpesvirus 6 in multiple sclerosis". Proceedings of the National Academy of Sciences of the United States of America. 92 (16): 7440–7444. doi:10.1073/pnas.92.16.7440. ISSN 0027-8424. PMID 7638210. 
  7. Lycke, J.; Svennerholm, B.; Hjelmquist, E.; Frisén, L.; Badr, G.; Andersson, M.; Vahlne, A.; Andersen, O. (Mar 1996). "Acyclovir treatment of relapsing-remitting multiple sclerosis. A randomized, placebo-controlled, double-blind study". Journal of Neurology. 243 (3): 214–224. doi:10.1007/bf00868517. ISSN 0340-5354. PMID 8936350. 
  8. Bech, E.; Lycke, J.; Gadeberg, P.; Hansen, H. J.; Malmeström, C.; Andersen, O.; Christensen, T.; Ekholm, S.; Haahr, S. (Jan 8, 2002). "A randomized, double-blind, placebo-controlled MRI study of anti-herpes virus therapy in MS". Neurology. 58 (1): 31–36. doi:10.1212/wnl.58.1.31. ISSN 0028-3878. PMID 11781402. 
  9. Cuende, J. I.; Civeira, P.; Diez, N.; Prieto, J. (Sep 1997). "High prevalence without reactivation of herpes virus 6 in subjects with chronic fatigue syndrome". Anales De Medicina Interna. 14 (9): 441–444. ISSN 0212-7199. PMID 9453750. 
  10. 10.010.1 "HHV-6 Treatment". HHV-6 Foundation. Retrieved Mar 1, 2020. 
  11. Prichard, Mark N.; Whitley, Richard J. (Dec 2014). "The Development of New Therapies for Human Herpesvirus 6". Current opinion in virology. 0: 148–153. doi:10.1016/j.coviro.2014.09.019. ISSN 1879-6257. PMC 4267975Freely accessible. PMID 25462447. 
  12. Aoki, R; Kobayashi, N; Suzuki, G; Kuratsune, H; Shimada, K; Oka, N; Takahashi, M; Yamadera, W; Iwashita, M; Tokuno, S; Nibuya, M; Tanichi, M; Mukai, Y; Mitani, K; Kondo, K; Ito, H; Nakayama, K (2016). "Human herpesvirus 6 and 7 are biomarkers for fatigue, which distinguish between physiological fatigue and pathological fatigue". Biochemical and Biophysical Research Communications. 478 (1): 424-30. doi:10.1016/j.bbrc.2016.07.010. PMID 27396623. 
  13. Schreiner, Philipp; Harrer, Thomas; Scheibenbogen, Carmen; Lamer, Stephanie; Schlosser, Andreas; Naviaux, Robert K.; Prusty, Bhupesh K. (Apr 1, 2020). "Human Herpesvirus-6 Reactivation, Mitochondrial Fragmentation, and the Coordination of Antiviral and Metabolic Phenotypes in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome". ImmunoHorizons. 4 (4): 201–215. doi:10.4049/immunohorizons.2000006. ISSN 2573-7732. PMID 32327453. 
  14. Shikova, Evelina; Reshkova, Valentina; Kumanova, Аntoniya; Raleva, Sevdalina; Alexandrova, Dora; Capo, Natasa; Murovska, Modra (2020). "Cytomegalovirus, Epstein-Barr virus, and human herpesvirus-6 infections in patients with myalgic еncephalomyelitis/chronic fatigue syndrome". Journal of Medical Virology. doi:10.1002/jmv.25744. ISSN 1096-9071. 

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