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Clinical Microbiology Reviews, January 2005, p. 217-245, Vol. 18, No. 1
0893-8512/05/$08.00+0     doi:10.1128/CMR.18.1.217-245.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Update on Human Herpesvirus 6 Biology, Clinical Features, and Therapy

Leen De Bolle, Lieve Naesens,* and Erik De Clercq

Rega Institute for Medical Research, Katholieke Universiteit Leuven, Leuven, Belgium

Human herpesvirus 6 (HHV-6) is a betaherpesvirus that is closely related to human cytomegalovirus. It was discovered in 1986, and HHV-6 literature has expanded considerably in the past 10 years. We here present an up-to-date and complete overview of the recent developments concerning HHV-6 biological features, clinical associations, and therapeutic approaches. HHV-6 gene expression regulation and gene products have been systematically characterized, and the multiple interactions between HHV-6 and the host immune system have been explored. Moreover, the discovery of the cellular receptor for HHV-6, CD46, has shed a new light on HHV-6 cell tropism. Furthermore, the in vitro interactions between HHV-6 and other viruses, particularly human immunodeficiency virus, and their relevance for the in vivo situation are discussed, as well as the transactivating capacities of several HHV-6 proteins. The insight into the clinical spectrum of HHV-6 is still evolving and, apart from being recognized as a major pathogen in transplant recipients (as exemplified by the rising number of prospective clinical studies), its role in central nervous system disease has become increasingly apparent. Finally, we present an overview of therapeutic options for HHV-6 therapy (including modes of action and resistance mechanisms).

* Corresponding author. Mailing address: Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, Minderbroedersstraat 10, B-3000 Leuven, Belgium. Phone: 3216-337345. Fax: 3216-337340. E-mail: lieve.naesens{at}rega.kuleuven.ac.be.

Clinical Microbiology Reviews, January 2005, p. 217-245, Vol. 18, No. 1
0893-8512/05/$08.00+0     doi:10.1128/CMR.18.1.217-245.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.



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Antimicrob. Agents Chemother. Clin. Vaccine Immunol.
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Copyright © 2005 by the American Society for Microbiology. All rights reserved.