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Human herpesvirus 6 infection in children: Clinical manifestations, diagnosis, and treatment

Cécile Tremblay, MD
Michael T Brady, MD
Section Editor
Sheldon L Kaplan, MD
Deputy Editor
Mary M Torchia, MD


The clinical manifestations, diagnosis, and treatment of human herpesvirus 6 (HHV-6) infection in children will be discussed here. The virology, pathogenesis, and epidemiology of HHV-6, the clinical manifestations, diagnosis, and treatment of HHV-6 infections in adults, and HHV-6 infection in hematopoietic cell transplant recipients are discussed separately. (See "Virology, pathogenesis, and epidemiology of human herpesvirus 6 infection" and "Clinical manifestations, diagnosis, and treatment of human herpesvirus 6 infection in adults" and "Human herpesvirus 6 infection in hematopoietic cell transplant recipients".)


HHV-6 is a member of the Herpesviridae family. HHV-6 replicates in activated CD4+ T lymphocytes [1]. Like other herpesviruses, HHV-6 establishes latency after primary infection and may reactivate in immunocompromised hosts, especially after allogeneic hematopoietic cell transplantation (HCT). (See "Human herpesvirus 6 infection in hematopoietic cell transplant recipients".)

There are two HHV-6 species: HHV-6A and HHV-6B. HHV-6B causes the majority of documented primary infections and reactivations events. Little is known about the epidemiology or clinical implications of HHV-6A. (See "Virology, pathogenesis, and epidemiology of human herpesvirus 6 infection", section on 'Virology and pathogenesis'.)


HHV-6 infects most children within the first two years of life [2,3], but rarely may be acquired in adulthood [4]. In developed countries, the rate of seroprevalence among adults is generally >70 percent. (See "Virology, pathogenesis, and epidemiology of human herpesvirus 6 infection", section on 'Epidemiology'.)

Transmission occurs mainly through saliva. Perinatal transmission has been documented (see 'Congenital infection' below); transmission through breast milk has not been reported [5]. Transmission through organ or hematopoietic cell donation has been reported rarely [6-9], but transmission through blood transfusion has not [5].

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Literature review current through: Nov 2017. | This topic last updated: Jul 26, 2016.
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