• Clinical science

Herpes virus infections


Human herpesviruses (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 learning cards. Follow the links provided in the overview table below.


HHV -Subtypes Characteristics Mode of transmission Disease
HHV-1 Herpes simplex virus 1 (HSV-1)
  • Seroprevalence: ≥ 90% in adults
  • Antivirals may be indicated (see acyclovir)
  • After primary infection, the virus remains dormant in nerve ganglia (typically trigeminal).
  • Saliva
  • Respiratory secretions
HHV-2 Herpes simplex virus 2 (HSV-2)
  • Seroprevalence: 10–30% in adults
  • Antivirals may be indicated (see acyclovir)
  • After primary infection, the virus remains dormant in nerve ganglia (typically sacral).
  • Sexual intercourse
  • Perinatal
HHV-3 Varicella zoster virus (VZV)
  • Seroprevalence: up to 90%
  • Antivirals may be indicated (see acyclovir).
  • Vaccinations are widely used to prevent VZV infections in children.
  • Respiratory secretions
  • Vesicular fluid
HHV-4 Epstein-Barr virus (EBV)
  • Seroprevalence: ≥ 65% in children[3]
  • Oncogenic potential: can immortalize and transform host B cells
  • Uses CD21 receptor to cause infection in B cells
  • Saliva
  • Respiratory secretions
HHV-5 Cytomegalovirus (CMV)
  • Seroprevalance: ∼ 40% in children in the US
  • Morphologic features of infected cells: "Owl-eye appearance"
  • Antivirals may be indicated (see ganciclovir, foscarnet, and fomivirsen).
  • Uses integrins to cause infection
  • Virus spreads early.
  • To be determined
HHV-8 Kaposi's sarcoma-associated virus (KSHV)
  • Seroprevalence: < 10% in the US
  • Seroprevalence is higher in men who have sex with men (MSM) and HIV-positive patients.
  • Sexual intercourse

  • 1. Greenberg MI. Greenberg's Text-atlas of Emergency Medicine. Lippincott Williams & Wilkins; 2005: p. 428.
  • 2. Ravikiran Ongole, Praveen B N. Textbook of Oral Medicine, Oral Diagnosis and Oral Radiology. Elsevier Health Sciences; 2014: p. 176.
  • 3. 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. . 2013. url: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0064921.
  • CDC. Cytomegalovirus (CMV) and Congenital CMV Infection. http://www.cdc.gov/cmv/overview.html. Updated June 17, 2016. Accessed November 2, 2016.
  • Akhter K. Cytomegalovirus. In: Bronze MS. Cytomegalovirus. New York, NY: WebMD. http://emedicine.medscape.com/article/215702-overview. Updated August 12, 2015. Accessed November 2, 2016.
  • Akhter K. Cytomegalovirus Clinical Presentation. In: Bronze MS. Cytomegalovirus Clinical Presentation. New York, NY: WebMD. http://emedicine.medscape.com/article/215702-clinical. Updated August 12, 2015. Accessed November 2, 2016.
  • Gabriella Campadelli-FiumeComments to Author , Prisco Mirandola, and Laura Menotti. Human Herpesvirus 6: An Emerging Pathogen. http://wwwnc.cdc.gov/eid/article/5/3/99-0306_article. Updated December 10, 2010. Accessed November 2, 2016.
  • 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.
  • Rose LJ. Kaposi Sarcoma. In: Harris JE. Kaposi Sarcoma. New York, NY: WebMD. http://emedicine.medscape.com/article/279734-overview#a6. Updated April 16, 2015. Accessed November 2, 2016.
last updated 12/14/2018
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