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Human herpesvirus 6A (HHV-6A) and 6B (HHV–6B) are members of the genus Roseolovirus in the Betaherpesvirinae subfamily. HHV-6B infects humans in the first years of life, has a seroprevalence of more than 90% and causes Roseola Infantum, but less is known about HHV-6A. While most other herpesviruses maintain their latent genome as a circular episome, HHV-6A and HHV-6B (HHV-6A/B) have been shown to integrate their genome into the telomeres of infected cells. HHV-6A/B can also integrate into the chromosomes of germ cells, resulting in individuals carrying a copy of the virus genome in every nucleated cell of their bodies. This review highlights our current understanding of HHV-6A/B integration and reactivation as well as aspects that should be addressed in the future of this relatively young research area. It forms part of an online symposium on the prevention and therapy of DNA virus infections, dedicated to the memory of Mark Prichard.
•HHV-6A/B carry telomeric repeat arrays (TMR) identical to the host telomere sequences at the ends of their genomes.•HHV-6A/6B integrate their genome into the telomeres of infected cells.•HHV-6A/6B can integrate in germ cells and become heritable from parent to offspring.•HHV-6A/6B TMR facilitate this integration likely mediated by virus and host factors.•The integrated HHV-6 genome can reactivate resulting in virus replication.