Human Herpesvirus Type 6 Medication

  • Author: Michelle R Salvaggio, MD; Chief Editor: Burke A Cunha, MD   more...
 
Updated: Dec 5, 2011
 

Medication Summary

  • The role of antiviral therapy for human herpesvirus 6 (HHV-6) infection has yet to be determined.
  • Therapy is usually unnecessary in primary infection in immunocompetent hosts.
  • In immunosuppressed hosts in whom active HHV-6 infection has been documented, some studies have suggested using antiviral therapy in cases of hepatitis, bone marrow suppression, pneumonitis, or encephalitis. In particular, they recommend ganciclovir or foscarnet. Ganciclovir has also been reported to be beneficial against HHV-6 reactivation in patients undergoing stem cell transplantation.
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Antivirals

Class Summary

Nucleoside analogs are initially phosphorylated by viral thymidine kinase to eventually form a nucleoside triphosphate, resulting in the inhibition of viral replication.

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Ganciclovir (Cytovene, Vitrasert)

 

Acyclic nucleoside analog of 2'-deoxyguanosine that inhibits replication of herpes viruses both in vitro and in vivo.

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Foscarnet (Foscavir)

 

Organic analog of inorganic pyrophosphate that inhibits replication of known herpesviruses. Inhibits viral replication at pyrophosphate-binding site on virus-specific DNA polymerases. Poor clinical response or persistent viral excretion during therapy may be due to viral resistance.

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Contributor Information and Disclosures
Author

Michelle R Salvaggio, MD  Assistant Professor, Department of Internal Medicine, Section of Infectious Diseases, University of Oklahoma College of Medicine; Medical Director of Infectious Diseases Institute, University of Oklahoma Health Sciences Center

Michelle R Salvaggio, MD is a member of the following medical societies: American College of Physicians and Infectious Diseases Society of America

Disclosure: Merck Honoraria Speaking and teaching

Coauthor(s)

Peter S Miele  MD, Medical Officer, Division of Antiviral Products, U.S. Food and Drug Administration

Peter S Miele is a member of the following medical societies: American College of Physicians-American Society of Internal Medicine and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Margo A Smith, MD  Associate Program Director, Department of Medicine, Washington Hospital Center; Assistant Professor, Department of Internal Medicine, Section of Infectious Diseases, George Washington University

Margo A Smith, MD is a member of the following medical societies: American Society for Microbiology

Disclosure: Nothing to disclose.

Specialty Editor Board

Thomas J Marrie, MD  Dean of Faculty of Medicine, Dalhousie University Faculty of Medicine, Canada

Thomas J Marrie, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Society for Microbiology, Canadian Infectious Disease Society, and Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Ronald A Greenfield, MD  Professor, Department of Internal Medicine, University of Oklahoma College of Medicine

Ronald A Greenfield, MD is a member of the following medical societies: American College of Physicians, American Federation for Medical Research, American Society for Microbiology, Central Society for Clinical Research, Infectious Diseases Society of America, Medical Mycology Society of the Americas, Phi Beta Kappa, Southern Society for Clinical Investigation, and Southwestern Association of Clinical Microbiology

Disclosure: Pfizer Honoraria Speaking and teaching; Gilead Honoraria Speaking and teaching; Ortho McNeil Honoraria Speaking and teaching; Abbott Honoraria Speaking and teaching; Astellas Honoraria Speaking and teaching; Cubist Honoraria Speaking and teaching; Forest Pharmaceuticals Speaking and teaching

Eleftherios Mylonakis, MD  Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital

Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD  Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital

Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

References

  1. Pellett PE, Ablashi DV, Ambros PF, Agut H, Caserta MT, Descamps V, et al. Chromosomally integrated human herpesvirus 6: questions and answers. Rev Med Virol. Nov 4 2011;[Medline].

  2. Agut H. Deciphering the clinical impact of acute human herpesvirus 6 (HHV-6) infections. J Clin Virol. Nov 2011;52(3):164-71. [Medline].

  3. Merk J, Schmid FX, Fleck M, et al. Fatal pulmonary failure attributable to viral pneumonia with human herpes virus 6 (HHV6) in a young immunocompetent woman. J Intensive Care Med. Sep-Oct 2005;20(5):302-6. [Medline].

  4. Singh N. Infections with Human Herpesvirus 6, 7, and 8 after hematopoietic stem cell or solid organ transplantation. In: Bowden R, Ljungman P, Paya C. Transplant Infections. 2nd. Philadelphia: Lippincott Williams & Wilkins; 2004:365-374.

  5. Betts BC, Young JA, Ustun C, Cao Q, Weisdorf DJ. Human herpesvirus 6 infection after hematopoietic cell transplantation: is routine surveillance necessary?. Biol Blood Marrow Transplant. Oct 2011;17(10):1562-8. [Medline].

  6. Kunisaki Y, Goto H, Kitagawa K, et al. Salazosulfapyridine induced hypersensitivity syndrome associated with reactivation of humanherpes virus 6. Intern Med. Feb 2003;42(2):203-7. [Medline].

  7. Hasegawa A, Yasukawa M, Sakai I, et al. Transcriptional down-regulation of CXC chemokine receptor 4 induced by impaired association of transcription regulator YY1 with c-Myc in human herpesvirus 6-infected cells. J Immunol. Jan 15 2001;166(2):1125-31. [Medline].

  8. Challoner PB, Smith KT, Parker JD, et al. Plaque-associated expression of human herpesvirus 6 in multiple sclerosis. Proc Natl Acad Sci U S A. Aug 1 1995;92(16):7440-4. [Medline].

  9. Tejada-Simon MV, Zang YC, Hong J, et al. Cross-reactivity with myelin basic protein and human herpesvirus-6 in multiple sclerosis. Ann Neurol. Feb 2003;53(2):189-97. [Medline].

  10. Mori T, Mihara A, Yamazaki R, et al. Myelitis associated with human herpes virus 6 (HHV-6) after allogeneic cord blood transplantation. Scand J Infect Dis. 2007;39(3):276-8. [Medline].

  11. Burns WH, Sandford GR. Susceptibility of human herpesvirus 6 to antivirals in vitro. J Infect Dis. Sep 1990;162(3):634-7. [Medline].

  12. Chapnick EK, Lutwick LI. Human Herpesvirus 6 (HHV-6). Infectious Disease Practice. 1995;19:91-94.

  13. Cirone M, Cuomo L, Zompetta C, et al. Human herpesvirus 6 and multiple sclerosis: a study of T cell cross-reactivity to viral and myelin basic protein antigens. J Med Virol. Oct 2002;68(2):268-72. [Medline].

  14. Cone RW, Huang ML, Corey L, et al. Human herpesvirus 6 infections after bone marrow transplantation: clinical and virologic manifestations. J Infect Dis. Feb 1999;179(2):311-8. [Medline].

  15. Dockrell DH, Smith TF, Paya CV. Human herpesvirus 6. Mayo Clin Proc. Feb 1999;74(2):163-70. [Medline].

  16. Fox JD, Briggs M, Ward PA, et al. Human herpesvirus 6 in salivary glands. Lancet. Sep 8 1990;336(8715):590-3. [Medline].

  17. Fujita H, Maruta A, Tomita N, et al. Human herpesvirus-6-associated exanthema in a patient with acute lymphocytic leukaemia. Br J Haematol. Mar 1996;92(4):947-9. [Medline].

  18. Gutierrez J, Vergara MJ, Guerrero M, et al. Multiple sclerosis and human herpesvirus 6. Infection. Jun 2002;30(3):145-9. [Medline].

  19. Hashimoto K, Yasukawa M, Tohyama M. Human herpesvirus 6 and drug allergy. Curr Opin Allergy Clin Immunol. Aug 2003;3(4):255-60. [Medline].

  20. Hukin J, Farrell K, MacWilliam LM, et al. Case-control study of primary human herpesvirus 6 infection in children with febrile seizures. Pediatrics. Feb 1998;101(2):E3. [Medline].

  21. Janoly-Dumenil A, Galambrun C, Basset T, et al. Human herpes virus-6 encephalitis in a paediatric bone marrow recipient: successful treatment with pharmacokinetic monitoring and high doses of ganciclovir. Bone Marrow Transplant. Dec 2006;38(11):769-70. [Medline].

  22. Kimberlin DW, Whitley RJ. Human herpesvirus-6: neurologic implications of a newly-described viral pathogen. J Neurovirol. Oct 1998;4(5):474-85. [Medline].

  23. Knox KK, Carrigan DR. Disseminated active HHV-6 infections in patients with AIDS. Lancet. Mar 5 1994;343(8897):577-8. [Medline].

  24. Liedtke W, Malessa R, Faustmann PM, et al. Human herpesvirus 6 polymerase chain reaction findings in human immunodeficiency virus associated neurological disease and multiple sclerosis. J Neurovirol. Sep 1995;1(3-4):253-8. [Medline].

  25. Singh N, Carrigan DR. Human herpesvirus-6 in transplantation: an emerging pathogen. Ann Intern Med. Jun 15 1996;124(12):1065-71. [Medline].

  26. Swanborg RH, Whittum-Hudson JA, Hudson AP. Infectious agents and multiple sclerosis--are Chlamydia pneumoniae and human herpes virus 6 involved?. J Neuroimmunol. Mar 2003;136(1-2):1-8. [Medline].

  27. Tokimasa S, Hara J, Osugi Y, et al. Ganciclovir is effective for prophylaxis and treatment of human herpesvirus-6 in allogeneic stem cell transplantation. Bone Marrow Transplant. Apr 2002;29(7):595-8. [Medline].

  28. Tyler KL. Human herpesvirus 6 and multiple sclerosis: the continuing conundrum. J Infect Dis. May 1 2003;187(9):1360-4. [Medline].

  29. Villoslada P, Juste C, Tintore M, et al. The immune response against herpesvirus is more prominent in the early stages of MS. Neurology. Jun 24 2003;60(12):1944-8. [Medline].

  30. Volin L, Lautenschlager I, Juvonen E, et al. Human herpesvirus 6 antigenaemia in allogeneic stem cell transplant recipients: impact on clinical course and association with other beta-herpesviruses. Br J Haematol. Sep 2004;126(5):690-6. [Medline].

  31. Yamanishi K. Human herpesvirus 6 and human herpesvirus 7. In: Clinical Virology. First ed. New York, NY: Churchill Livingston; 1997:471-81 TEXTBOOK.

  32. Zerr DM, Corey L, Kim HW, et al. Clinical outcomes of human herpesvirus 6 reactivation after hematopoietic stem cell transplantation. Clin Infect Dis. Apr 1 2005;40(7):932-40. [Medline].

 
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