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Herpes virus infections

Last updated: October 14, 2020

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Human herpes viruses (HHV) are a large family of DNA viruses that remain dormant in a host following primary infection. An overview of the eight subtypes known to cause various diseases (ranging from asymptomatic to fatal disease courses) in humans is provided below. The specific conditions caused by the various HHVs are discussed in separate articles. Follow the links provided in the overview table below.

Human herpes viruses (HHV) are members of a large family of DNA viruses, Herpesviridae, that infect humans. Human herpes viruses are classified into three main groups: [1]

Overview of human herpes viruses
Human herpes virus Subtypes Seroprevalence Mode of transmission Characteristics Disease Management
HHV-1 Herpes simplex virus 1 (HSV-1)
  • ≥ 50% in adults [2]
  • Saliva
  • Respiratory secretions
  • Antivirals may be indicated (see “Acyclovir.”)
HHV-2 Herpes simplex virus 2 (HSV-2)
  • 10–20% in adults [2]
  • After primary infection, the virus remains dormant in nerve ganglia (typically sacral ganglia).
  • Antivirals may be indicated. (see “Acyclovir.”)
HHV-3 Varicella zoster virus (VZV)
  • Up to 90% [3]
  • Respiratory secretions
  • Vesicular fluid
HHV-4 Epstein-Barr virus (EBV)
  • 65% in children, teens, and young adults between 6 and 19 years old [4]
  • Oncogenic potential: can immortalize and transform host B cells
  • Uses CD21 receptor to cause infection in B cells
  • Symptomatic therapy
  • Avoid physical activity that may trigger splenic rupture (e.g., contact sports) for at least 3 weeks
HHV-5 Cytomegalovirus (CMV)
  • ∼ 50% in the US [5]
  • ∼ 90% in the US [7]
  • Saliva
  • Virus spreads early. [8][9]
  • Reactivation of latent virus or reinfection may occur later in life (especially if individuals become immunocompromised).
  • Symptomatic treatment to reduce fever
HHV-8 Kaposi's sarcoma-associated virus (KSHV)
  • Sexual intercourse
  • Has oncogenic potential
  • Infects endothelial cells causing malignant, multifocal, highly vascularized tumor
  • Treatment of the underlying disease (e.g., antiretroviral treatment in patients with HIV)

  1. Whitley RJ. Medical Microbiology. Herpesviruses. University of Texas Medical Branch at Galveston ; 1996
  2. Bradley H, Markowitz LE, Gibson T, McQuillan GM. Seroprevalence of Herpes Simplex Virus Types 1 and 2--United States, 1999-2010. J Infect Dis. 2013; 209 (3): p.325-333. doi: 10.1093/infdis/jit458 . | Open in Read by QxMD
  3. Reynolds MA, Kruszon-Moran D, Jumaan A, Schmid DS, McQuillan GM. Varicella Seroprevalence in the U.S.: Data from the National Health and Nutrition Examination Survey, 1999–2004. Public Health Rep. 2010; 125 (6): p.860-869. doi: 10.1177/003335491012500613 . | Open in Read by QxMD
  4. Dowd JB, Palermo T, Brite J, McDade TW, Aiello A. Seroprevalence of Epstein-Barr Virus Infection in U.S. Children Ages 6-19, 2003-2010. PLoS ONE. 2013; 8 (5): p.e64921. doi: 10.1371/journal.pone.0064921 . | Open in Read by QxMD
  5. Bate SL, Dollard SC, Cannon MJ. Cytomegalovirus Seroprevalence in the United States: The National Health and Nutrition Examination Surveys, 1988–2004. Clinical Infectious Diseases. 2010; 50 (11): p.1439-1447. doi: 10.1086/652438 . | Open in Read by QxMD
  6. Cytomegalovirus (CMV) and Congenital CMV Infection. Updated: June 17, 2016. Accessed: November 2, 2016.
  7. Caserta MT, McDermott MP, Dewhurst S, et al. Human herpesvirus 6 (HHV6) DNA persistence and reactivation in healthy children. J Pediatr. 2004; 145 (4): p.478-484. doi: 10.1016/j.jpeds.2004.06.016 . | Open in Read by QxMD
  8. Human Herpesvirus 6: An Emerging Pathogen. Updated: December 10, 2010. Accessed: November 2, 2016.
  9. Vincent C Emery and Duncan A. Clark. HHV-6A, 6B, and 7: persistence in the population, epidemiology and transmission. Cambridge University Press : p. Chapter 49