Clinicians HHV-6 Treatment

HHV-6 Treatment

Although there are no drugs approved specifically for the treatment of HHV-6 infection, drugs used to treat closely-related cytomegalovirus (CMV) are widely used off-label for HHV-6. Patients with severe HHV-6 reactivation are treated with with intravenous ganciclovir (Cytovene),  foscarnet (Foscavir) or  cidofovir (Vistide). Ganciclovir is also available in an oral form, known as valganciclovir (Valcyte).

Current antivirals used in the treatment of acute HHV-6 infection 

Drug Name

Brand Name(s)**

Structure

Main Use**

Target

In Vitro Selectivity against HHV-6

Cross BBB?

Clinical Risks**

(Val)Ganciclovir

Cytovene, Valcyte

Nucleoside analogue

CMV

Viral Polymerase

Moderate

Yes

Bone Marrow Suppression

Cidofovir

Vistide

Nucleotide analogue

CMV

Viral Polymerase

Good

Minimal

Renal Toxicity

Foscarnet

Foscavir

Pyrophosphate analogue

CMV

Viral Polymerase

Excellent

Yes

Renal Toxicity

**As reported by the United States’ Food and Drug Administration (FDA)

 

Both foscarnet and cidofovir must be administered with a great deal of hydration to avoid kidney toxicity. Typically a full liter of water is given by IV before each dose of foscarnet. Probenecid is given with cidofovir to protect the kidney.

Valcyte is the only oral medication effective for HHV-6 & CMV and is commonly used in transplant patients to prevent reactivation of herpesviruses. It was also used in a study by infectious disease specialist Jose Montoya at Stanford University to  treat patients with cognitive dysfunction and elevated antibodies to HHV-6 and EBV.

In an in vitro study at The Rega Institute funded by the Foundation, the influenza antiviral and Parkinson’s drug amantadine generated a reproducible inhibition of HHV-6 replication, albeit at relatively high (subtoxic) concentrations. Researchers at the Rega institute also found lamotrigine, an anti-epileptic drug, was effective against HHV-6B but not HHV-6A (Naesens et al, 2006).

 

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