Epstein-Barr virus (EBV) and human herpes virus type 8 (HHV-8), also known as Kaposi’s sarcoma-associated herpes virus (KSHV) known tumor diseases can cause. Roseola infantum is a childhood disease which is caused by the herpes virus 6 (and sometimes 7).
Eight types of herpes viruses cause infections in humans (see table: herpes viruses that infect humans). After the initial infection, all herpesviruses persist latently within specific host cells and can be reactivated later. Herpes viruses can not survive for long outside a host cell; Therefore, a transmission usually requires close contact. In people with latent infection the virus can reactivate to cause no symptoms; in such cases, asymptomatic shedding occurs and people can transmit the infection. Epstein-Barr virus (EBV) and human herpes virus type 8 (HHV-8), also known as Kaposi’s sarcoma-associated herpes virus (KSHV) known tumor diseases can cause. Roseola infantum is a childhood disease which is caused by the herpes virus 6 (and sometimes 7). Herpes viruses that infect humans Common Name Other name Typical manifestations herpes simplex virus type 1 human herpesvirus 1 gingivostomatitis, keratoconjunctivitis, cutaneous herpes, genital herpes, encephalitis, herpes labialis, viral meningitis, oesophagitis *, pneumonia *, hepatitis *, Herpes simplex virus type 2 human herpesvirus 2 causes genital herpes, cutaneous herpes gingivostomatitis, neonatal herpes, viral meningitis, disseminated infection * hepatitis * Varicella zoster virus human herpesvirus 3 chickenpox, herpes zoster, disseminated herpes zoster * Epstein-Barr virus human herpesvirus 4 Infectious mononucleosis, hepatitis, encephalitis, nasopharyngeal carcinoma, Hodgkin’s lymphoma, Burkitt’s lymphoma, lymphoproliferative syndrome * oral hairy leukoplakia * cytomegalovirus Human herpesvirus 5 CMV-mononucleosis, hepatitis, congenital cytomegalovirus infection, hepatitis * * retinitis, pneumonia *, colitis * Human herpesvirus 6 – roseola otitis media with fever, encephalitis human herpesvirus 7 – roseola infantum Kaposi’s sarcoma-associated herpes virus human herpesvirus 8 No known associated acute disease, but plays a causal role in Kaposi’s sarcoma * and AIDS-related non -Hodgkin lymphomas, which grow as Effusionslymphome especially in pleural, pericardial or abdominal cavities connected also with the multicentric Castleman’s disease * In immunocompromised hosts. Causes in immunocompetent hosts occasional fulminant hepatitis without skin lesions. Drug treatment of herpes viruses to the drugs that are effective against herpes viruses belong u. a. Acyclovir, cidofovir, famciclovir, Fomivirsen, foscarnet, ganciclovir, idoxuridine, penciclovir, trifluridine, valacyclovir, valganciclovir and vidarabine (see Table: drugs used to treat herpes virus infections). Drugs for the treatment of herpes virus infections drug effect applications side effects acyclovir effective against (in decreasing order of potency) HSV type 1 (HSV-1), HSV-2, VZV and EBV minimal activity against CMV oral or intravenous acyclovir is indicated when, as z. Example in herpes simplex encephalitis, a higher drug serum levels is required. Oral: Rare i.v. : Occasionally, renal toxicity by precipitation of acyclovir crystals; in immunocompromised patients (TTP / HUS) cidofovir in vitro inhibition of a wide range of viruses, including HSV-1, HSV-2, VZV, CMV, EBV, KSHV, adenovirus, HPV, and human polyoma virus (JC and BK viruses) IV: Generally used against CMV, but by challenging Darreichungsregime and significant renal toxicity, the use is limited. Significant renal toxicity famciclovir (prodrug of penciclovir) antiviral spectrum similar to acyclovir (strains that are resistant to acyclovir, are also against famciclovir) Oral: Just as effective as acyclovir in genital herpes and herpes zoster, and more bioavailable than acyclovir (after oral administration which the Einstzes with VZV infection / reactivation) rare fomivirsen Very theoretically important in the case good activity against CMV (antisense oligonucleotide inhibits CMV protein synthesis) intravitreal injection in patients with HIV infection and CMV retinitis, in which a resistance over and ere treatment options exist. Elevated intraocular pressure, to corticosteroids responsive uveitis foscarnet effective against EBV, KSHV, human herpes virus 6, acyclovir-resistant (and acyclovir-sensitive) HSV and VZV, as well as to ganciclovir-resistant (and ganciclovir-sensitive) CMV Certain antiretroviral activity against HIV. Very good CNS marketability IV: The efficacy is comparable to the treatment and delay of progression of CMV retinitis of renal ganciclovir toxicity up to a third of patients when foscarnet is administered without proper hydration, electrolyte imbalances: subjectively poorly tolerated due to the triggering of a metabolic acidosis with continuous infusion. Ganciclovir in vitro activity against all herpesviruses, incl. CMV, but acyclovir-resistant strains are also cross-resistant to ganciclovir Typical treatment of choice for CMV is used in HIV patients with CMV retinitis i.v. Application: Most commonly Oral: Only 6 to 9% bioavailable; there are 12 capsules per day is required as a standard dose (1 g 3 times / day), which limits its usefulness Primarily, bone marrow suppression, primarily neutropenia, which sometimes * requires treatment idoxuridine effective against HSV-1, HSV-2, VZV, vaccinia and CMV topically: Due to its high systemic toxicity limited to the topical use in the herpes simplex keratoconjunctivitis irritation, pain, photophobia, itching, inflammation and edema of the eyelids Rarely, allergic reactions penciclovir effective against HSV-1, HSV-2, VZ V, CMV, EBV and topically (cream): is in recurrent herpes labialis in adults used erythema trifluridine (trifluorothymidine) effective against HSV-1 and HSV-2 Topical Ophthalmic treatment of primary keratoconjunctivitis and recurrent keratitis or ulceration caused by HSV-1 and HSV-2 caused systemic use excluded by bone marrow stinging of the eyes, eyelid edema Less commonly, punctate keratitis, allergic reactions valacyclovir (prodrug: prodrug of acyclovir) Antiviral spectrum corresponds to that of acyclovir Oral: 3-5 times more bioavailable than acyclovir similar to those of acyclovir TTP / HUS in some patients with advanced HIV infection and in transplant patients receiving valacyclovir in higher doses than currently recommended valganciclovir (prodrug of ganciclovir) Corresponds to ganciclovir oral: Muddled (Editor’s note: for the induction treatment of CMV retinitis) as two 450 mg tablets (= 900 mg) 2 times per day. (Editor’s note: When the prophylaxis or maintenance therapy 900 mg 1 time per day); (More bioavailable than oral ganciclovir) Similar to ganciclovir vidarabine (adenine arabinoside, ara-A) In HSV infections due to neurotoxicity, it is no longer i.v. used Ophthalmic formulations: effect of acute HSV-1 or HSV-2-induced keratoconjunctivitis and recurrent superficial keratitis. Superficial punctate keratitis with increased lacrimation, irritation, pain and photophobia. Severe neutropenia (<500 neutrophils / uL) may need one of the following: bone marrow stimulation with granulocyte colony stimulating factor or granulocyte-macrophage colony stimulating factor discontinuation of ganciclovir dose reduction valaciclovir should be used with caution in patients with advanced HIV infection and transplant patients are used. CMV = cytomegalovirus; EBV = Epstein-Barr virus, HPV = human papillomavirus; HSV = herpes simplex virus; KSHV = Kaposi's sarcoma-associated herpes virus; TTP / HUS = thrombotic thrombocytopenic purpura and hemolytic rämisches syndrome; VZV = varicella-zoster virus.