Upcoming Virtual and In-Person Educational Events for Patients and Medical Professionals ➜ VIEW NOW

Learn about tick-borne illness, how it can become chronic, the challenges with traditional treatment options, and how patients can begin healing.

Cytomegalovirus (CMV) Infections

by Dr. Jamie Kunkle

Cytomegalovirus (CMV) is generally VERY similar to Epstein Barr Virus (EBV) and Human Herpes Herpesvirus 6 (HHV-6), but it tends to be more treatment-resistant than common prescription antivirals like acyclovir.

CMV is extremely common, infecting between 60% to 70% of adults in industrialized countries and close to 100% in emerging countries (though it is slightly less recognized than EBV in lab testing).

Although it is often asymptomatic in healthy adults, CMV can be fatal in infants and life-threatening in immunocompromised individuals.

Similar to EBV, once acquired, this virus can replicate at any time during one’s life and represents a lifelong burden of antigenic T-cell surveillance and immune dysfunction.

Congenital CMV is a leading infectious cause of deafness, learning disabilities, and intellectual disability.

Human CMV infections commonly affect the salivary glands. It is also associated with some Cancers; namely mucoepidermoid carcinoma and some prostate cancers.

Common symptoms of CMV that contrast EBV and HHV-6:

  • May present as a more severe encephalopathy/encephalitis.
  • More dangerous in utero, infants, and early childhood.
  • May be more likely to affect the eyes and visual processing.
  • May see more liver and gut involvement at times.
  • Generally, treatment-resistant (if using pharmaceuticals may require valganciclovir, a fairly potent antiviral).
  • Tends to co-infect other chronic neurologic-associated infections like Bartonella.

Human Herpes Virus 6 (HHV-6):

There are technically TWO strains that exist for HHV-6 (HHV-6A and HHV-6B), but they are difficult to differentiate effectively through testing. The majority of infections are caused by HHV-6B. This virus induces a lifelong latent infection in humans, similar to other herpesviruses.

HHV-6 can infect multiple types of tissue but preferentially infects CD4 T-lymphocytes. Other tissues susceptible to infection are monocytes/macrophages, salivary glands, brain, and kidneys.

Associated conditions include:

  • Multiple sclerosis
  • Malignancy
  • Infectious mononucleosis
  • Drug hypersensitivity syndromes
  • Skin eruptions

Primary infection of HHV-6 may present as exanthema subitum (AKA Roseola, AKA Sixth Disease), a self-limiting disease of infancy.

Viral reactivations can induce severe encephalitis in all ages.

HSV-1 and HSV-2

Largely considered the “sexually transmitted” or STI herpesviruses.
Common cause of cold sores (HSV-1) and genital herpes lesions (HSV-2).
May cause encephalitis and other neurologic symptoms.

Varicella/Herpes Zoster:

  • Causes chickenpox in early infancy and shingles in adulthood.
  • Chickenpox is fairly rare with the addition of the varicella vaccine to childhood scheduling.
  • Despite adult vaccination for shingles, cases are still fairly common, especially in the COVID-19 era.
  • Acute chickenpox results in a skin rash that forms small, itchy blisters that scab over, typically starting on the chest, back, and face and then spreading.
  • Acute infection may present with fever, fatigue, pharyngitis, and headaches, which usually last five to seven days.
  • Complications include pneumonia, brain inflammation, and bacterial skin infections.
  • Shingles most often affects adults and is typically more severe than childhood chicken pox.
  • Lesions often follow a single dermatome (nerve root) on one side of the body.
  • Lesions/rashes can be itchy, painful and sometimes cause chronic neuralgia (nerve pain).
  • Infection of nerves can be dangerous and permanent, including nerves around the eyes or other vital structures.
  • Symptoms begin ten to 21 days after exposure, but the average incubation period is about two weeks.


  • Often neglected amongst herpesviruses clinically.
  • Considered for a long time only to infect immune-compromised individuals, but this notion is brought into question with the rise of encephalitis cases, especially in the COVID-19 era.
  • HHV-7 may cause a severe encephalitis infection with epileptic seizures as its clinical manifestation.
  • Tends to infect lymphocytes and has a high tropism for the central nervous system.