Chapter

Introductory Chapter:
Human Herpesvirus - A Short
Introduction
Ronaldo Luis Thomasini

1. Introduction

The relationship between herpesviruses and humans probably proceeds from

thousands of years. In the last decades, many aspects of herpesviral infections
have been understood since infections with a severe outcome to mild or subclinical
manifestations. Several conditions have been related to herpesviral reactivation
since complications in transplant-organ recipients to immune regulatory modifica-
tion in the elderly.
The manifestations caused by the herpesvirus simples in the oral region are
classically known. Manifestations with labial lesions and sometimes stomatitis can
occur in a considerable part of the population at some point in the individual’s life.
Usually, these lip lesions are self-limiting although they are often recurrent [1].
Other herpesviruses have been considered as emerging pathogens in the etiology of
different diseases.
Human herpesviruses belong to the family Herpesviridae, they are ubiquitous
viruses and once the first infection occurs, they remain in the body of the affected
individual (latency) during the lifetime. These viruses cause a wide variety of
diseases, and infections are often benign, but may in immunocompromised indi-
viduals cause clinical manifestations with different level of severity [2, 3].
The Herpesviridae family is divided into 3 subfamilies: Alphaherpesvirinae
(α-herpesvirinae), Betaherpesvirinae (β-herpesvirinae) and Gammaherpesvirinae
(γ-herpesvirinae). These are distinguished by their viral and structural characteris-
tics, as well as by their pathogenic potential. All types of viruses classified into this

Virus Synonymous Subfamily Abbreviation

Human herpesvirus 1 Herpes simplex-1 α HSV-1/HHV-1

Human herpesvirus 2 Herpes simplex-2 α HSV-2/HHV-2

Human herpesvirus 3 Varicella-zoster α VZV/HHV-3

Human herpesvirus 4 Epstein-Barr γ EBV/HSV-4

Human herpesvirus 5 Cytomegalovirus β CMV/HHV-5

Human herpesvirus 6 None β HHV-6

Human herpesvirus 7 None β HHV-7

Human herpesvirus 8 None γ KSHV/HHV-8

Table 1.
Members of the human herpesvirus family.

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Human Herpesvirus Infection - Biological Features, Transmission, Symptoms, Diagnosis...

family are double-stranded DNA viruses and the different types of herpes viruses
share similar structural characteristics. List of herpesviruses that infect humans are
summarized in Table 1 [2, 3].
Herpesvirus group can establish primary infections with nonsevere symptoms,
which can result in an efficient immune response that prevents a new infection.
However, the virus is not completely eliminated, its genome remains within cells
without productive infection. Latent infections may become active (reactiva-
tion) due to factors related to the host and these manifestations allow the spread
of herpesviruses, since a release of extracellular virions occurs which can infect
other cells [4].

2. The human herpesviruses

2.1 Herpesvirus simplex 1 and 2

Human herpesviruses type 1 and 2 (HSV-1 and HSV-2) are usually associated
with herpes and genital herpes, respectively. However, genital herpes may be a
consequence of HSV-1 infection and cold sores may also be caused by HSV-2. Once
the individual has been infected, reactivation is extremely common in both clinical
forms: oral or genital. The lesions are bullous and painful although it tends to disap-
pear in a few intervals of time [5, 6].
In some individual, especially in severely immunocompromised patients but not
only but also in individuals with a moderate or mild reduction in immune response,
in particular, cell-mediated, these viruses can cause more severe disease such central
nervous system affections. The frequent labial and genital herpes recurrence show
that severe immunosuppression is not a sine qua non condition to herpes simples
reactivation.

2.2 Varicella-zoster virus

Human herpesvirus type 3 (Varicella-zoster) causes varicella (chickenpox) in a

primary infection that occurs especially in children and reactivation can cause the
onset of zoster that is more frequent in the elderly. Neurologic zoster is an impor-
tant complication of this infection, especially in elderly and immunosuppressed
patients [7, 8].
Varicella in children is often benign although rarely could cause hepatitis and
encephalitis. In adults, varicella tends to cause more severe outcomes, and the fact
is not completely understood. Zoster is related to decrease of the self-reported
level of satisfaction with the life and depression in the elderly. Besides the zoster
being frequently recurrent, the pain remains for several weeks after the lesions
have disappeared. Fortunately, the vaccination is available for both children [9]
and elderly [10] and it will probably lead to a decrease of incidence not only of
varicella but also of zoster due to the consequence of reactivation of VZV which
remained from a Varicella episode. However, in the elderly, the prescription of
vaccination must be carefully made to avoid complications caused by a vaccine
containing attenuated viruses.

2.3 Epstein-Barr virus

Human herpesvirus type 4 (Epstein-Barr virus; EBV) is associated with infec-

tious mononucleosis, Burkitt’s lymphoma, and nasopharyngeal carcinoma. The
most important aspect of EBV is its oncogenic potential. A majority of cases of

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Introductory Chapter: Human Herpesvirus - A Short Introduction
DOI: http://dx.doi.org/10.5772/intechopen.89557

EBV infection have a low impact on the individual; however, a complication such as
hepatitis [11], lymphoproliferative syndrome [12], and encephalitis can rarely occur
[13]. There is no vaccine to prevent EBV infection; however, concerning a progres-
sive putative relation with the pathogenesis of several types of tumors, a possibility
of the development of a vaccine must be considered.

2.4 Cytomegalovirus

Primary cytomegalovirus infection causes a “mononucleosis-like syndrome”

known as cytomegaly or “cytomegalic inclusion disease.” Cytomegalovirus is not
well known by the general public because it causes often not severe clinical condi-
tions. The impact of cytomegalovirus infection HIV-infected [14] and transplant
patients [15] is well recognized. Most recently, the cytomegalovirus has been associ-
ated with immunosenescence and, perhaps, frailty syndrome in the elderly [16]. It
is not clear whether is the virus that modulates the immune system as a mechanism
of evasion or the immune system declines along with the aging and to allow the
virus replication.

2.5 Human herpesviruses 6 and 7

Primary HHV-6 and HHV-7 infections cause a common early febrile infectious
syndrome known as roseola infantum or exanthem subitum [17]. The HHV-6 has
been related to transplant rejection and graft-versus-host disease in bone marrow
transplantation [18]. In other types of transplantation, the HHV-6 effects are much
less related. HHV-7 have been studied in several types of conditions but its influence
remains still not clear.

2.6 Human herpesviruses 8

Human herpesvirus type 8 is associated with Kaposi’s sarcoma and can lead
to death in immunosuppressed patients, especially acquired immunodeficiency
syndrome (HIV/AIDS) [19].

3. Conclusions

In the last decades, a large number of research regarding herpesviruses have

been published. Although a considerable number of conditions are irrefutably
linked to a specific type of herpesvirus, many others remain well less explained and
with lack of cause-effect definitions. It is clear that further studies must be designed
with the aim of better understanding each hypothesis. The status quo about the
knowledge about the human herpesvirus simples, varicella-zoster virus, and
cytomegalovirus was presented and discussed in this book.

Conflict of interest

The author declares that there is no conflict of interest.

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Human Herpesvirus Infection - Biological Features, Transmission, Symptoms, Diagnosis...

Author details

Ronaldo Luis Thomasini

Faculty of Medicine of Diamantina, Federal University of Jequitinhonha and
Mucuri Valleys, Diamantina, Brazil

*Address all correspondence to: ronaldothomasini@gmail.com

© 2020 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms
of the Creative Commons Attribution License (http://creativecommons.org/licenses/
by/3.0), which permits unrestricted use, distribution, and reproduction in any medium,
provided the original work is properly cited.

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Introductory Chapter: Human Herpesvirus - A Short Introduction
DOI: http://dx.doi.org/10.5772/intechopen.89557

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