New and evolving therapies are slowly making headway in the management of HHV infections, Dr. Heymann says, witnessed by the drop in frequency of varicella zoster virus infections. According to Dr. Heymann, the ongoing research for potential vaccines for the Epstein-Barr virus would be especially important going forward in immunosuppressed patients to potentially prevent the subsequent lymphomas that can occur. Most recently, the roseola virus is increasingly being associated with its potential role in DRESS syndrome, a drug reaction in part characterized by eosinophilia and systemic symptoms or drug-induced hypersensitivity.
“There is a lot going on in terms of the recognition of atypical presentations of these viruses in immune-compromised patients, their disease associations as well as potential therapeutic measures. We have to be aware of these changes on the horizon that may alter our approach to patients who are at risk of complications, especially lymphoproliferative complications,” Dr. Heymann says.
Dr. Heymann advises that clinicians should consider performing appropriate laboratory tests in these settings, which could include biopsy as well as viral culture and serologies because there may be certain circumstances when treating the viral infection may be of immediate benefit to the patient.