Human herpesvirus 6-induced inflammatory cardiomyopathy in immunocompetent children

Surabhi Reddy, Eva Eliassen, Gerhard R. Krueger, Bibhuti B. Das

Research output: Contribution to journalReview articlepeer-review

13 Scopus citations


Over the last decade, human herpesvirus 6 (HHV-6) has been implicated in the etiology of pediatric myocarditis and subsequent dilated cardiomyopathy (DCM). This review provides an overview of recent literature investigating the pathophysiological relevance of HHV-6 in inflammatory cardiomyopathy. We examined 11 cases of previously published pediatric myocarditis and/or DCM associated with HHV-6 and also our experience of detection of virus particles in vascular endothelium of HHV-6 positive endomyocardial biopsy tissue by electron microscopy. The exact role of the presence of HHV-6 and its load remains controversial as the virus is also found in the heart of healthy controls. Therefore, the question remains open whether and how cardiac HHV-6 may be of pathogenetic importance. Quantitative polymerase chain reaction or mRNA testing allows differentiation between low-level latent virus found in asymptomatic myocardium and active HHV-6 infection. Although only a small number of pediatric cases have been reported in literature, HHV-6 should be considered as a causative agent of inflammatory cardiomyopathy, especially in children under three who might be experiencing a primary infection. Future studies are needed to establish a threshold for determining active infection in biopsy samples and the role of coinfections other cardiotropic viruses.

Original languageEnglish (US)
Pages (from-to)259-268
Number of pages10
JournalAnnals of Pediatric Cardiology
Issue number3
StatePublished - Sep 1 2017


  • Human herpesvirus 6 cardiomyopathy
  • myocarditis in children
  • pediatric-dilated cardiomyopathy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine


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