Understanding the role of HHV-6 in D.R.E.S.S.
It's difficult to discuss DRESS without recognizing the important role that the Human Herpes Virus 6 HHV-6 plays in this condition. In the world of severe cutaneous adverse drug reactions, the virus, HHV-6 preferentially reactivates in DRESS patients, occurring in over 50% of cases.
While it has long been controversial as to the exact development of this virus in DRESS, it is well known amongst the medical experts that those who develop HHV-6 tend to have a more severe course of illness including late flare in symptoms and organ failure. Identifying reactivation of HHV-6 can help aid in diagnosis of DRESS. In fact, it is part of the definition of this condition DIHS (drug induced hypersensitivity syndrome) in Japan. While there currently are no internationally approved guidelines for the treatment of HHV-6, the use of antivirals has proven effective in some clinical cases and may be indicated in severe DRESS.