Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 09.02.2021

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HHV-6A; HHV-6B; Human herpes virus 6; Human Herpesvirus 6A, Human Herpesvirus 6B

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The HHV-6 virus (Human Herpesvirus 6) belongs to the order Herpesvirales in the family: Herpesviridae, the subfamily: Betaherpesvirinae, the genus: Roseolovirus, the species: Human Herpesvirus 6A, 6B; HHV-6A; HHV-6B.

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The former viral species "Human herpesvirus 6, HHV-6 is elevated to the rank of species according to the ICTV (International Committee on Taxonomy of Viruses; 2019) into the two subtypes A and B.

Human herpesvirus type 6A and human herpesvirus type6B (HHV-6A and HHV-6B) are 2 human pathogenic species of the viral genus Roseolovirus from the Betaherpesvirus subfamily (Lautenschläger S 2018).

General information
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HHV-6A and HHV-6B are practically ubiquitously distributed viruses. At least 80 % of the adult population is seropositive.

Clinical picture
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In general, the first infection with HHV-6B occurs in 95% of cases before the age of 2. The infection occurs by droplet infection and is usually clinically inapparent.

Symptomatic infection manifests as three-day fever(exanthema subitum).

Acute HHV-6- infection may also present with fever and status epilepticus (Mohammadpour Touserkani F et al. 2017).

In adults, primary infection is associated with a highly febrile clinical picture with maculo-papular exanthema, lymphadenopathy, and possible complicating hepatitis and meningoencephalitis (Costa BKD et al. 2019). HHV-6B-induced encephalitis is an important cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (Ward KN et al. 2019).

HHV-6 appears to be implicated in pityriasis rosea.

HHV-6 also appears to play a pathogenetic role in the diseases listed below: Gianotti-Crosti syndrome, thrombocytopenic purpura, Stevens-Johnson syndrome, graft-versus-host reaction.

Similarly, it is suspected that there is an association between reactivation of HHV-6 and the severity of DRESS syndrome (Míguez-Martín L et al. 2019). Furthermore, HHV-6 is thought to be a possible cofactor in basal cell carcinoma and squamous cell carcinoma. To date, no diseases have been associated with the HHV-6A species (the former HHV-6 subtype A).

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The virus can be cultivated in lymphocyte cultures from saliva or pharyngeal lavage water. Another possibility is the detection of its nucleic acids in blood lymphocytes by means of PCR.

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  1. Costa BKD et al (2019) Viral encephalitis: a practical review on diagnostic approach and treatment. J Pediatr (Rio J) pii: S0021-7557(19)30429-2
    Kobayashi N et al (2019) Attenuation of human herpesvirus 6B reactivation by aging. J Med Virol 91:1335-1341.
  2. Lute S (2018) Human herpes viruses. In: Braun-Falco`s Dermatology, Venerology Allergology G. Plewig et al. (Hrsg) Springer Verlag S 124
  3. Míguez-Martín L et al (2019) Delayed aminopenicillin reaction associated to human herpes virus 6 infection mimicking DRESS syndrome. Rev Alerg Mex 66:375-378.
  4. Mohammadpour Touserkani F et al (2017) HHV-6 and seizure: A systematic review and meta-analysis. J Med Virol 89:161-169.
  5. Ward KN et al (2019) Guidelines from the 2017 European Conference on Infections in Leukaemia for management of HHV-6 infection in patients with hematological malignancies and after hematopoietic stem cell transplantation. Haematologicapii: haematol.2019.223073.


Last updated on: 09.02.2021