What is the mode of transmission for Human Herpesvirus (HHV)?

From the Guidelines

Transmission of Human Herpesvirus (HHV) occurs primarily through direct contact with infected bodily fluids, including skin-to-skin contact, kissing, sexual activity, and exposure to saliva, respiratory droplets, or other secretions from an infected person. The most common transmission routes vary depending on the type of HHV. According to the 1999 USPHS/IDSA guidelines for the prevention of opportunistic infections in persons infected with human immunodeficiency virus 1, epidemiologic evidence suggests that sexual transmission of HHV-8 is likely among men who have sex with men and can occur among heterosexuals as well. However, the virus has been detected more frequently in saliva than in semen from HHV-8-seropositive HIV-infected persons. Some key points to consider include:

• The mechanism of transmitting HHV-8 is not fully understood, but sexual transmission and transmission through saliva are possible routes 1.
• HIV-infected persons should use latex condoms during every act of sexual intercourse to reduce the risk for exposure to sexually transmitted pathogens, including HHV-8 1.
• Prevention of disease and recurrence involves potent antiretroviral drug combinations that suppress HIV replication, which can reduce the frequency of KS in HIV-infected persons 1.
• Effective suppression of HIV replication with antiretroviral drugs in HIV-infected patients with KS might prevent KS progression or the development of new lesions 1.

From the Research

Transmission of HHV

• The provided studies do not directly address how one gets HHV, but rather focus on the treatment and management of HHV infections, particularly HHV-6 encephalitis 2, 3, 4.
• However, it can be inferred that HHV transmission may occur through various means, such as:
  • Close contact with an infected individual
  • Organ transplantation, as seen in the case of hematopoietic stem cell transplant recipients 2
  • Other routes of transmission, although not explicitly stated in the provided studies

Risk Factors for HHV Infection

• Certain individuals may be at a higher risk of developing HHV infections, including:
  • Immunocompromised patients, such as those undergoing hematopoietic stem cell transplantation 2
  • Individuals with weakened immune systems, although this is not directly stated in the provided studies
• The use of certain medications, such as mycophenolic acid, may also enhance the activity of antiviral agents against HHV 3

Treatment and Management of HHV Infections

• Various antiviral agents have been studied for their effectiveness against HHV infections, including:
  • Foscarnet, ganciclovir, and cidofovir, which have shown potent activity against HHV-6, HHV-7, and HHV-8 3
  • Combination therapy with foscarnet and ganciclovir may reduce sequelae, but not mortality, secondary to HHV-6 encephalitis 2
• High-dose ganciclovir has been used to treat HHV-6 encephalitis in an immunocompetent child, with initial recovery and some neurologic sequelae 4