This post is for anyone supporting the narrative about Herpes Simplex Virus that “it’s not a big deal”. This is to encourage NIH for more urgency for treatment research, cure, and serology testing. This is to urge the CDC to develop a real prevention strategy including testing and tracking. Herpes Simplex Virus requires treatment and prevention now for the “massive portion of the worlds population” who are living with the virus. It is time to stop minimizing its impacts, because Herpes is certainly not benign.

Neonatal Herpes

The global incidence of neonatal herpes has been estimated to be around 10 cases per 100,000 live births which is equivalent to about 14,000 cases per year.

Neonatal infection with herpes simplex virus (HSV) is a devastating complication of genital herpes during pregnancy. It is associated with considerable morbidity and mortality: untreated, the case-fatality rate is estimated to be 60%. Even with antiviral treatment, mortality rates and lasting neurological impairment remain substantial, especially for neonates with CNS disease (about 30% of cases) and disseminated disease (25% of cases) compared with those with skin, eyes, and mucosa disease (around 45% of cases).

Bell’s Palsy

There has been increasing acceptance of HSV-1 and varicella zoster virus as the cause of Bell’s Palsy. Bell’s Palsy may result when HSV ruptures from the nerve axon, infects the Schwann sheath, and progresses centripetally. When the swelling caused by the herpetic endoneuritis reaches the enclosed space of the bony fallopian canal, compression of the facial nerve results in paralysis.

Other infectious diseases have been implicated as well.

Increased Risk of HIV

Herpes is a widely recognized driver of the HIV/AIDS epidemic. 40% of new HIV cases are HSV-related, meaning 420,000 new cases of HIV every year could be prevented with a Herpes cure. Infection with HSV-2 increases the risk of HIV acquisition 2-4 fold compared with patients without HSV-2 infection.

Even without lesions present, studies show HSV-2 creates an immune-cell environment conducive to HIV infection that persists at the location of HSV-2 genital skin lesions long after they have been treated with oral doses of the drug acyclovir and have healed and the skin appears normal.

A vaccine against HSV infection would not only help to promote and protect the health and well-being of millions of people, particularly women, worldwide – it could also potentially have an impact on slowing the spread of HIV, if developed and provided alongside other HIV prevention strategies

Dr Meg Doherty,
Director of the WHO Department of Global HIV, Hepatitis, and STI Programmes.

Meningitis

Aseptic meningitis occurs in 36% of women with primary HSV-2 genital infection and 13% of men5; it results in hospitalization for 6.4% of infected women and 1.6% of infected men.

Recurrent aseptic meningitis due to HSV-2 may occur with or without symptomatic herpetic mucocutaneous disorder. The manifestations of this disorder are identical to that observed with primary genital herpes. 8 in 1 series, recurrent meningitis has been observed in 19% 8 to 42% 9 of patients who experience meningitis with their first episode of genital herpes.

Neurological complications

It is widely recognized that chronic infection of the central nervous system causes neurological complications. With the virus chronically present in the body, there is an immune response that is chronically activated, causing inflammation and complications in the nervous system including the brain.

HSV encephalitis (HSE), is the most common fatal sporadic encephalitis in humans. About 90% of all HSE cases in adults and children are due to HSV-1. While the exact incidence of HSE is not known, it has been estimated at about one case per million per year. This figure is probably an underestimate since about 2000 cases occur annually in the United States.

Though rare, encephalitis can be a complication of HSV-1, while HSV-2 is more generally a suspected factor in the development of meningitis. However, the meninges are not the only component of the CNS involved in HSV-2 infection.

Virtually any part of the neuraxis may be affected by this virus, including the retina, brain, brainstem, cranial nerves, spinal cord, nerve pain and nerve roots.

Autoimmune Disorders

In the recent years, several reports have provided important information linking HHV-6A/B to autoimmune diseases (AD) including multiple sclerosis, autoimmune connective tissue diseases, and Hashimoto’s thyroiditis. In addition, it has been suggested that HHV-6A/B infection might be related to the onset of autoimmune disorders, including Sjögren’s syndrome, purpura fulminans, severe autoimmune acquired protein S deficiency severe and acute autoimmune hepatitis and autoimmune hemolytic anemia/neutropenia.

Alzheimer’s and Dementia

There is mounting evidence of a link between Herpes with Alzheimer’s and dementia. Herpes may account for 50% of Alzheimer’s cases. Infection increases likelihood by 2-3%.

Recent research, published in Science Advances, is the first to directly show in a lab model (rather than through circumstantial evidence from human studies) that the herpes simplex virus HSV-1 might cause Alzheimer’s: Human brain-like tissue infected with the virus became riddled with amyloid plaque-like formations — the hallmark of Alzheimer’s. It also developed neuroinflammation and became less effective at conducting electrical signals, all of which happen in Alzheimer’s disease.

Depression, Anxiety, Stress

Psychosocial impacts from Herpes can be severe including depression, low self-esteem and anger. HSV is a known cause of emotional trauma and stress due to the both the burden of disease (oral and/or genital lesions), it’s impacts on quality of life and relationships. Research shows a link between depressed individuals and the herpes simplex virus. The STI project estimates that 10% of Herpes carriers consider suicide.

Genital herpes is a substantial health concern worldwide – beyond the potential pain and discomfort suffered by people living with the infection, the associated social consequences can have a profound effect on sexual and reproductive health.

Dr Ian Askew
Director of the Department of Sexual and Reproductive Health and Research at WHO

Gastrointestinal

Research has suggested that the herpes virus spread from the genitals to nerves in the spinal chord, and then on to neurons in the colon, killing them. In this study, the damage to the colonic neurons prevented the movement of food along the digestive tract, leading to an enlarged colon and disease.

Women’s Health

Research has indicated that Herpes is a risk factor for women for other infections of the genitalia or vagina including Bacterial Vaginosis. This study implies that HSV-2 infection is an important BV risk factor. Pharmacologic HSV-2 suppression may reduce BV incidence and BV-associated adverse events. BV can increase risk of HIV transmission, induce spontaneous abortion, or early labor in pregnancy.

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