Human betaherpesvirus 7

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Human betaherpesvirus 7
a,b) Presence of herpesvirus-7 positive cells in the PCR+ samples
SpecialtyInfectious disease

Human betaherpesvirus 7 (HHV-7) is one of nine known members of the Herpesviridae family that infects humans. HHV-7 is a member of Betaherpesvirinae, a subfamily of the Herpesviridae that also includes HHV-6 and Cytomegalovirus (HHV-5 or HCMV).[1][2] HHV-7 often acts together with HHV-6, and the viruses together are sometimes referred to by their genus, Roseolovirus.[3] HHV-7 was first isolated in 1990 from CD4+ T cells taken from peripheral blood lymphocytes.[4]

Signs and symptoms

Both HHV-6B and HHV-7, as well as other viruses, can cause a skin condition in infants known as exanthema subitum, although HHV-7 causes the disease less frequently than HHV-6B.[5] HHV-7 infection also leads to or is associated with a number of other symptoms, including acute febrile respiratory disease, fever, rash, vomiting, diarrhea, low lymphocyte counts,[6] and febrile seizures,[7] though most often no symptoms present at all.[8]

There are indications that HHV-7 can contribute to the development of drug-induced hypersensitivity syndrome (DIHS),[9] encephalopathy,[10] hemiconvulsion-hemiplegia-epilepsy syndrome,[11] hepatitis infection,[12] postinfectious myeloradiculoneuropathy,[13] pityriasis rosea,[14] and the reactivation of HHV-4, leading to "mononucleosis-like illness".[15] Drug reaction with eosinophilia and systemic symptoms (DRESS) is a specific type of DIHS that may be linked to HHV-7 as the condition may develop in response to herpesvirus antigens. In one study, 76% of the 40 examined patients with DRESS exhibited some reactivation of Epstein-Barr virus, HHV-6, or HHV-7. Additionally, HHV-7 is currently suspected as a causative agent of lichen planus. In one dermatologic study, 33 skin biopsies were performed and HHV-7 was found at higher rates in lichen planus lesions. Remission of lichen planus was also associated with lower levels of HHV-7.[16] HHV-7 was also detected in 79.3% of cervical tissue examined, indicating that sexual contact may be a route of transmission for HHV-7.[17]

Notably, HHV-7 and HHV-6 were detected in 56.3% of unspecified encephalopathy cases examined, with more HHV-7 positive cells in the gray matter of the frontal and temporal lobes HHV-7 is typically present in astrocytes and oligodendrocytes in the cerebral cortex, deep nuclei, and cerebellum.[18] HHV-7 infection, along with HSV1, VZV, and HHV6, was associated with increased risk of dementia.[19] However, further research is needed further elucidate the causative and correlative factors between HHV-7 and encephalopathy.[18]

Complications with HHV-7 infection has been shown to be a factor in a great variety of transplant types.[8] Specifically, HHV-7 infection has been linked to a reactivation of cytomegalovirus (CMV) infection in renal transplant patients and may be linked to graft-vs-host disease.[16]

Virology

Human betaherpesvirus 7
Virus classification e
(unranked): Virus
Realm: Duplodnaviria
Kingdom: Heunggongvirae
Phylum: Peploviricota
Class: Herviviricetes
Order: Herpesvirales
Family: Orthoherpesviridae
Genus: Roseolovirus
Species:
Human betaherpesvirus 7
Synonyms[20]
  • Human herpesvirus 7

Structure

A mature virus particle measures about 170 nanometres (1,700 Å) in diameter.[21]

The genome of HHV-7 is very similar to that of HHV-6, although it is about 10% smaller,[22] with a DNA genome of about 145,000 base pairs.[8] There are a number of key differences between the genome of HHV-7 and that of HHV-6, but the importance of them for viral DNA replication is not yet known.[8]

Additionally, the HHV-7 virion appears to share much structural similarity to the HHV-6 virion. Despite this, some morphological characteristics of the viruses differ.[21]

Cellular effects

HHV-7 resides mostly in CD4+ T cells,[23] albeit only in certain strains of them.[24][25][26] To enter CD4+ T cells, HHV-7, unlike HHV-6, uses CD4 and possibly some cell-surface glycoproteins to enter CD4+ T cells.[27] Despite this, HHV-7 may be able to enter cells that do not express the CD46 receptor.[28] About a week after HHV-7 has infected a cell, it begins to downregulate CD4 transcription,[29] which interferes with HIV-1 infection[30] but may reactivate HHV-6 infection.[31] It is however unclear exactly what effect HHV-7 has on HIV infection.[8]

There has been some inquiry into the relationship between HHV-7 and HIV-1 co-receptors CXCR4 and CCR5. During infection, HHV-7 causes a loss of CXCR4 in CD4+ T-cells in addition to lowering intracellular Ca2+ flux and chemotaxis in response to stroll cell-derived factor 1 (SDF-1). Additionally, a CXCR4 antagonist that was effective against HIV was shown to be ineffective at inhibiting HHV-7. This information indicates that CXCR4 and CCR5 are not essential receptor proteins for HHV-7 infection.[28]

The trademark indication of HHV-7 infection at the cellular level is the presence of aforementioned syncytia. It is thought that these cells form via polyploidization resulting from a dysregulation of cyclin dependent kinase cdc2 and cyclin B. Giant cells form when the cell cycle is disrupted and accumulate between the G2 and M phase.[28] However, syncytia formation is more complex than initially thought. Some research has shown that syncytia formation in betaherpesviruses can vary based on the type of envelop protein expressed by the virion as well as the particular type of cell that the virus is infecting.[32]

HHV-7 also notably activates IL-15 upon infection. Activation of IL-15 leads to an increased natural killer (NK) cell response. This is thought to be one of the immune system's main methods of responding to HHV-7 infection.[28]

HHV-7 also has a number of other effects on cells. Among these include membrane leaking, the presence of lytic syncytia,[33][34] occasional apoptosis,[35] the supporting of latent infection,[36] and increases and decreases in levels of certain cytokines.[37][38]

Entry

HHV-7, like many other herpesviruses, relies on glycoproteins for entry. Specifically, HHV-7 is known to encode glycoproteins B, H, and L, but not C or D. In terms of betaherpesvirus specifically, it is thought that gB, gH, and gL are required for infection.[32] Additionally, HHV-7 encodes a glycoprotein complex (gp82-105) that is unique to HHV-7 and HHV-6.[39]

Diagnosis

In adults, the effects of HHV-7 separate from HHV-6 have not been well-researched.[1] One reason for this is because the detection of HHV-7 was at first difficult to do quickly, as the process for doing so involves a procedure that is difficult to do in commercial laboratories and because viral isolation and serological testing are long processes that do not lend themselves to finishing quickly. HHV-7 can be grown in various lymphocytes in vitro, but researchers have noted that the virus does not propagate well under laboratory conditions.[40] A process known as loop-mediated isothermal amplification (LAMP) has recently been applied to speed up detection of HHV-7, although a larger sample size of patients must be tested first to see if the test will still work across a broad range of subjects.[41] No reliable serological test has been developed yet for HHV-7 alone, but multiple are in the process of being developed.[8] The use of PCR assays to test for HHV-7 is also being explored.[8][42]

Treatment

No HHV-7 infection-specific treatment exists.[8] While HHV-7 may not be linked to any specific diseases, some researchers emphasize that the virus is still clinically relevant as it causes significant complications in immunocompromised patients. Specific treatment options for HHV-6, 7, and 8 are currently in the early stages of development. Some research suggests that acyclovir and anti-CMV drugs such as cidofovir and foscarnet may have some therapeutic benefit in HHV-7 infection. Additionally, some experimental drugs, such as cyclotriazadisulfonamide, and 9-R-2-phosphonomethoxypropyladenine may be effective against HHV-7. There is a need for HHV-7 specific treatments, however, because broad-spectrum antivirals are typically toxic and thus unsuitable for prophylactic use.[16]

Epidemiology

Over 95% of adults have been infected and are immune to HHV-7,[43] and over three quarters of those were infected before the age of six.[44] Primary infection of HHV-7 among children generally occurs between the ages of 2 and 5, which means it occurs after primary infection of HHV-6.[45] A 2014 Washington University School of Medicine's analysis of 102 healthy adults sampled at as many as five major body habitats found that HHV-7 was present in 98% of them, especially in the mouth.[46] A 2017 study looking at the human blood virome in 8,240 humans between the ages of 2 months to 102 years found that 20.37% of them were positive for HHV-7.[47]

References

  1. ↑ 1.0 1.1 "Other Herpesviruses: HHV-6, HHV-7, HHV-8, HSV-1 and -2, VZV". American Journal of Transplantation. 4 (Suppl 10): 66–71. 2004. doi:10.1111/j.1600-6135.2004.00697.x. PMID 15504215.
  2. ↑ Widen, B. F.; Lowings, J. P.; Belak, S.; Banks, M. (August 1999). "Development of a PCR system for porcine cytomegalovirus detection and determination of the putative partial sequence of its DNA polymerase gene". Epidemiology and Infection. 123 (1): 177–180. doi:10.1017/S0950268899002599. PMC 2810741. PMID 10487654.
  3. ↑ Ongrádi, JóZsef; Kövesdi, Valéria; Kováts, Enikő (2010). "Az emberi 7-es herpeszvírus". Orvosi Hetilap (in magyar). 151 (16): 645–51. doi:10.1556/OH.2010.28856. PMID 20353917.
  4. ↑ Frenkel, N; Schirmer, EC; Wyatt, LS; Katsafanas, G; Roffman, E; Danovich, RM; June, CH (1990). "Isolation of a new herpesvirus from human CD4+ T cells". Proceedings of the National Academy of Sciences of the United States of America. 87 (2): 748–52. Bibcode:1990PNAS...87..748F. doi:10.1073/pnas.87.2.748. PMC 53343. PMID 2153965.
  5. ↑ Cohen, J. I.; Fahle, G.; Kemp, M. A.; Apakupakul, K.; Margolis, T. P. (2010). "Human Herpesvirus 6-A, 6-B and 7 in Vitreous Fluid Samples". Journal of Medical Virology. 82 (6): 996–9. doi:10.1002/jmv.21751. PMC 2938775. PMID 20419813.
  6. ↑ Suga, S; Yoshikawa, T; Nagai, T; Asano, Y (1997). "Clinical features and virological findings in children with primary human herpesvirus 7 infection". Pediatrics. 99 (3): E4. doi:10.1542/peds.99.3.e4. PMID 9099769.
  7. ↑ Clark, DA; Kidd, IM; Collingham, KE; Tarlow, M; Ayeni, T; Riordan, A; Griffiths, PD; Emery, VC; Pillay, D (1997). "Diagnosis of primary human herpesvirus 6 and 7 infections in febrile infants by polymerase chain reaction". Archives of Disease in Childhood. 77 (1): 42–5. doi:10.1136/adc.77.1.42. PMC 1717251. PMID 9279150.
  8. ↑ 8.0 8.1 8.2 8.3 8.4 8.5 8.6 8.7 Tremblay, Cecile. Hirsch, Martin S; McGovern, Barbara H (eds.). "Human herpesvirus 7 infection". UpToDate. Archived from the original on 10 January 2024. Retrieved 21 September 2020.
  9. ↑ Hara, H; Kobayashi, M; Yokoyama, A; Tochigi, M; Matsunaga, A; Shimizu, H; Goshima, J; Suzuki, H (2005). "Drug-induced hypersensitivity syndrome due to carbamazepine associated with reactivation of human herpesvirus 7". Dermatology. 211 (2): 159–61. doi:10.1159/000086449. PMID 16088166. S2CID 41829848.
  10. ↑ Van Den Berg, JS; Van Zeijl, JH; Rotteveel, JJ; Melchers, WJ; Gabreëls, FJ; Galama, JM (1999). "Neuroinvasion by human herpesvirus type 7 in a case of exanthem subitum with severe neurologic manifestations". Neurology. 52 (5): 1077–9. doi:10.1212/wnl.52.5.1077. PMID 10102435. S2CID 32547148.
  11. ↑ Kawada, J; Kimura, H; Yoshikawa, T; Ihira, M; Okumura, A; Morishima, T; Hayakawa, F (2004). "Hemiconvulsion-hemiplegia syndrome and primary human herpesvirus 7 infection". Brain & Development. 26 (6): 412–4. doi:10.1016/j.braindev.2003.12.003. PMID 15275707. S2CID 21552203.
  12. ↑ Hashida, T; Komura, E; Yoshida, M; Otsuka, T; Hibi, S; Imashuku, S; Imashuku, S; Ishizaki, T; et al. (1995). "Hepatitis in Association With Human Herpesvirus-7 Infection". Pediatrics. 96 (4 Pt 1): 783–785. doi:10.1542/peds.96.4.783. PMID 7567349.
  13. ↑ Mihara, T; Mutoh, T; Yoshikawa, T; Yano, S; Asano, Y; Yamamoto, H (2005). "Postinfectious myeloradiculoneuropathy with cranial nerve involvements associated with human herpesvirus 7 infection". Archives of Neurology. 62 (11): 1755–7. doi:10.1001/archneur.62.11.1755. PMID 16286551.
  14. ↑ Chuh, A; Chan, H; Zawar, V (2004). "Pityriasis rosea--evidence for and against an infectious aetiology". Epidemiology and Infection. 132 (3): 381–390. doi:10.1017/S0950268804002304. PMC 2870116. PMID 15188706.
  15. ↑ Chiu, H-H; Lee, C-Y; Lee, P-I; Lin, K-H; Huang, L-M (1998). "Mononucleosis syndrome and coincidental human herpesvirus-7 and Epstein-Barr virus infection". Archives of Disease in Childhood. 78 (5): 479–480. doi:10.1136/adc.78.5.479. PMC 1717555. PMID 9659100.
  16. ↑ 16.0 16.1 16.2 Wolz, Michael M.; Sciallis, Gabriel F.; Pittelkow, Mark R. (2012-10-01). "Human Herpesviruses 6, 7, and 8 From a Dermatologic Perspective". Mayo Clinic Proceedings. 87 (10): 1004–1014. doi:10.1016/j.mayocp.2012.04.010. ISSN 0025-6196. PMC 3538396. PMID 22819486. Archived from the original on 2024-01-10. Retrieved 2023-12-03.
  17. ↑ Biganzoli, Patricia; Frutos, María Celia; Venezuela, Fernando; Mosmann, Jessica; Kiguen, Ana; Pavan, Jorge; Ferreyra, Leonardo; Cuffini, Cecilia (January 2020). "Detection of human herpesvirus 6 (HHV-6) and human herpesvirus 7 (HHV-7) DNA in endocervical samples from a positive and negative HPV woman of Córdoba, Argentina". Journal of Clinical Pathology. 73 (1): 30–34. doi:10.1136/jclinpath-2019-205795. ISSN 0021-9746. PMID 31315894. S2CID 197542736. Archived from the original on 2024-01-10. Retrieved 2023-12-03.
  18. ↑ 18.0 18.1 Skuja, Sandra; Svirskis, Simons; Murovska, Modra (2021-02-27). "Human Herpesvirus-6 and -7 in the Brain Microenvironment of Persons with Neurological Pathology and Healthy People". International Journal of Molecular Sciences. 22 (5): 2364. doi:10.3390/ijms22052364. ISSN 1422-0067. PMC 7956495. PMID 33673426.
  19. ↑ Mekli, Krisztina; Lophatananon, Artitaya; Cant, Rachel; Burns, Alistair; Dobson, Curtis B.; Itzhaki, Ruth F.; Muir, Kenneth R. (2022-10-12). van de Vijver, David A. M. C. (ed.). "Investigation of the association between the antibody responses to neurotropic viruses and dementia outcomes in the UK Biobank". PLOS ONE. 17 (10): e0274872. Bibcode:2022PLoSO..1774872M. doi:10.1371/journal.pone.0274872. ISSN 1932-6203. PMC 9555633. PMID 36223333. {{cite journal}}: Check |pmc= value (help)
  20. ↑ Davison, Andrew (27 January 2016). "Rename species in the family Herpesviridae to incorporate a subfamily designation" (PDF). International Committee on Taxonomy of Viruses (ICTV). Archived (PDF) from the original on 10 January 2024. Retrieved 13 March 2019.
  21. ↑ 21.0 21.1 Klussmann, J. P.; Krueger, E.; Sloots, T.; Berneman, Z.; Arnold, G.; Krueger, G. R. F. (1997). "Ultrastructural study of human herpesvirus-7 replication in tissue culture". Virchows Archiv. 430 (5): 417–426. doi:10.1007/s004280050051. PMID 9174632. S2CID 23966153.
  22. ↑ Nicholas, John (September 1996). "Determination and analysis of the complete nucleotide sequence of human herpesvirus 7". Journal of Virology. 70 (9): 5975–5989. doi:10.1128/JVI.70.9.5975-5989.1996. PMC 190618. PMID 8709220.
  23. ↑ Katsafanas, GC; Schirmer, EC; Wyatt, LS; Frenkel, N (1996). "In vitro activation of human herpesviruses 6 and 7 from latency". Proceedings of the National Academy of Sciences of the United States of America. 93 (18): 9788–92. Bibcode:1996PNAS...93.9788K. doi:10.1073/pnas.93.18.9788. PMC 38507. PMID 8790409.
  24. ↑ Berneman, ZN; Ablashi, DV; Li, G; Eger-Fletcher, M; Reitz Jr, MS; Hung, CL; Brus, I; Komaroff, AL; Gallo, RC (1992). "Human herpesvirus 7 is a T-lymphotropic virus and is related to, but significantly different from, human herpesvirus 6 and human cytomegalovirus". Proceedings of the National Academy of Sciences of the United States of America. 89 (21): 10552–10556. Bibcode:1992PNAS...8910552B. doi:10.1073/pnas.89.21.10552. PMC 50377. PMID 1332051.
  25. ↑ Mirandola, P; Secchiero, P; Pierpaoli, S; Visani, G; Zamai, L; Vitale, M; Capitani, S; Zauli, G (2000). "Infection of CD34(+) hematopoietic progenitor cells by human herpesvirus 7 (HHV-7)". Blood. 96 (1): 126–131. doi:10.1182/blood.V96.1.126. PMID 10891440.
  26. ↑ Yasukawa, M; Inoue, Y; Ohminami, H; Sada, E; Miyake, K; Tohyama, T; Shimada, T; Fujita, S (1997). "Human herpesvirus 7 infection of lymphoid and myeloid cell lines transduced with an adenovirus vector containing the CD4 gene". Journal of Virology. 71 (2): 1708–1712. doi:10.1128/JVI.71.2.1708-1712.1997. PMC 191236. PMID 8995705.
  27. ↑ Secchiero, P; Sun, D; De Vico, AL; Crowley, RW; Reitz Jr, MS; Zauli, G; Lusso, P; Gallo, RC (1997). "Role of the extracellular domain of human herpesvirus 7 glycoprotein B in virus binding to cell surface heparan sulfate proteoglycans". Journal of Virology. 71 (6): 4571–80. doi:10.1128/JVI.71.6.4571-4580.1997. PMC 191679. PMID 9151851.
  28. ↑ 28.0 28.1 28.2 28.3 Mori, Yasuko; Yamanishi, Koichi (2007), Arvin, Ann; Campadelli-Fiume, Gabriella; Mocarski, Edward; Moore, Patrick S. (eds.), "HHV-6A, 6B, and 7: pathogenesis, host response, and clinical disease", Human Herpesviruses: Biology, Therapy, and Immunoprophylaxis, Cambridge: Cambridge University Press, ISBN 978-0-521-82714-0, PMID 21348085, archived from the original on 2024-01-10, retrieved 2022-11-25
  29. ↑ Hall, CB (1997). "Human Herpesviruses at Sixes, Sevens, and More (editorial)". Annals of Internal Medicine. 127 (6): 481–3. CiteSeerX 10.1.1.365.5033. doi:10.7326/0003-4819-127-6-199709150-00010. PMID 9313006. S2CID 9448355.
  30. ↑ Lusso, P; Secchiero, P; Crowley, RW; Garzino-Demo, A; Berneman, ZN; Gallo, RC (1994). "CD4 is a critical component of the receptor for human herpesvirus 7: interference with human immunodeficiency virus". Proceedings of the National Academy of Sciences of the United States of America. 91 (9): 3872–6. Bibcode:1994PNAS...91.3872L. doi:10.1073/pnas.91.9.3872. PMC 43684. PMID 7909607.
  31. ↑ Tanaka-Taya, K; Kondo, T; Nakagawa, N; Inagi, R; Miyoshi, H; Sunagawa, T; Okada, S; Yamanishi, K (2000). "Reactivation of human herpesvirus 6 by infection of human herpesvirus 7". Journal of Medical Virology. 60 (3): 284–9. doi:10.1002/(SICI)1096-9071(200003)60:3<284::AID-JMV6>3.0.CO;2-8. PMID 10630960. S2CID 42600320.
  32. ↑ 32.0 32.1 Tang, Jiajia; Frascaroli, Giada; Zhou, Xuan; Knickmann, Jan; Brune, Wolfram (2021-09-30). "Cell Fusion and Syncytium Formation in Betaherpesvirus Infection". Viruses. 13 (10): 1973. doi:10.3390/v13101973. ISSN 1999-4915. PMC 8537622. PMID 34696402.
  33. ↑ Secchiero, P; Berneman, ZN; Gallo, RC; Lusso, P (1994). "Biological and molecular characteristics of human herpesvirus 7: in vitro growth optimization and development of a syncytia inhibition test". Virology. 202 (1): 506–12. doi:10.1006/viro.1994.1371. PMID 8009865. Archived from the original on 2024-01-10. Retrieved 2023-12-03.
  34. ↑ Frenkel, N; Schirmer, EC; Wyatt, LS; Katsafanas, G; Roffman, E; Danovich, RM; June, CH (1990). "Isolation of a new herpesvirus from human CD4+ T cells". Proceedings of the National Academy of Sciences of the United States of America. 87 (2): 748–52. Bibcode:1990PNAS...87..748F. doi:10.1073/pnas.87.2.748. PMC 53343. PMID 2153965.
  35. ↑ Secchiero, P; Flamand, L; Gibellini, D; Falcieri, E; Robuffo, I; Capitani, S; Gallo, RC; Zauli, G (1997). "Human Herpesvirus 7 induces CD4(+) T-cell death by two distinct mechanisms: necrotic lysis in productively infected cells and apoptosis in uninfected or nonproductively infected cells". Blood. 90 (11): 4502–12. PMID 9373261.
  36. ↑ Menegazzi, P; Galvan, M; Rotola, A; Ravaioli, T; Gonelli, A; Cassai, E; Di Luca, D (1999). "Temporal mapping of transcripts in human herpesvirus-7". Journal of General Virology. 80 (10): 2705–12. doi:10.1099/0022-1317-80-10-2705. PMID 10573164.{{cite journal}}: CS1 maint: url-status (link)
  37. ↑ Atedzoe, BN; Menezes, J; D'Addario, M; Xu, J; Ongradi, J; Ahmad, A (1999). "Modulatory effects of human herpes virus-7 on cytokine synthesis and cell proliferation in human peripheral blood mononuclear cell cultures". Journal of Leukocyte Biology. 66 (5): 822–8. doi:10.1002/jlb.66.5.822. PMID 10577515.{{cite journal}}: CS1 maint: url-status (link)
  38. ↑ Atedzoe, BN; Ahmad, A; Menezes, J (1997). "Enhancement of natural killer cell cytotoxicity by the human herpesvirus-7 via IL-15 induction". Journal of Immunology. 159 (10): 4966–72. doi:10.4049/jimmunol.159.10.4966. PMID 9366423. S2CID 42369655.
  39. ↑ Skrincosky, David; Hocknell, Peter; Whetter, Linda; Secchiero, Paola; Chandran, Bala; Dewhurst, Stephen (2000-05-15). "Identification and Analysis of a Novel Heparin-Binding Glycoprotein Encoded by Human Herpesvirus 7". Journal of Virology. 74 (10): 4530–4540. doi:10.1128/JVI.74.10.4530-4540.2000. ISSN 0022-538X. PMC 111973. PMID 10775589.
  40. ↑ Kempf, Werner (2002-08-01). "Human Herpesvirus 7 in Dermatology". American Journal of Clinical Dermatology. 3 (5): 309–315. doi:10.2165/00128071-200203050-00002. ISSN 1179-1888. PMID 12069636. S2CID 28402208. Archived from the original on 2024-01-10. Retrieved 2023-12-03.
  41. ↑ Yoshikawa, Tetsushi; Ihira, Masaru; Akimoto, Shiho; Usui, Chie; Miyake, Fumi; Suga, Sadao; Enomoto, Yoshihiko; Suzuki, Ryota; et al. (March 2004). "Detection of Human Herpesvirus 7 DNA by Loop-Mediated Isothermal Amplification". Journal of Clinical Microbiology. 42 (3): 1348–1352. doi:10.1128/JCM.42.3.1348-1352.2004. PMC 356854. PMID 15004116.
  42. ↑ Clark, D. A; Kidd, I M.; Collingham, K. E; Tarlow, M.; Ayeni, T.; Riordan, A.; Griffiths, P. D; Emery, V. C; Pillay, D. (1997). "Diagnosis of primary human herpesvirus 6 and 7 infections in febrile infants by polymerase chain reaction". Archives of Disease in Childhood. 77 (1): 42–45. doi:10.1136/adc.77.1.42. PMC 1717251. PMID 9279150.
  43. ↑ Clark, DA; Freeland, ML; MacKie, LK; Jarrett, RF; Onions, DE (1993). "Prevalence of antibody to human herpesvirus 7 by age". The Journal of Infectious Diseases. 168 (1): 251–2. doi:10.1093/infdis/168.1.251. PMID 8390545.
  44. ↑ Cermelli, C; Fabio, G; Montorsi, M; Sabbatini, AM; Portolani, M (1996). "Prevalence of antibodies to human herpesviruses 6 and 7 in early infancy and age at primary infection". New Microbiologica. 19 (1): 1–8. PMID 8673847.
  45. ↑ Yoshikawa, T (2003). "Human Herpesvirus-6 and -7 Infections in Transplantation". Pediatric Transplantation. 7 (1): 11–17. doi:10.1034/j.1399-3046.2003.02094.x. PMID 12581322. S2CID 32279697.
  46. ↑ Wylie, Kristine M.; Mihindukulasuriya, Kathie A.; Zhou, Yanjiao; Sodergren, Erica; Storch, Gregory A.; Weinstock, George M. (2014-01-01). "Metagenomic analysis of double-stranded DNA viruses in healthy adults". BMC Biology. 12: 71. doi:10.1186/s12915-014-0071-7. ISSN 1741-7007. PMC 4177058. PMID 25212266.
  47. ↑ Moustafa, Ahmed; Xie, Chao; Kirkness, Ewen; Biggs, William; Wong, Emily; Turpaz, Yaron; Bloom, Kenneth; Delwart, Eric; Nelson, Karen E. (2017-03-22). "The blood DNA virome in 8,000 humans". PLOS Pathogens. 13 (3): e1006292. doi:10.1371/journal.ppat.1006292. ISSN 1553-7374. PMC 5378407. PMID 28328962.

Further reading

Classification
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