Could Treatment for Herpes Virus Reduce Risk of Alzheimer’s Disease?

MedicalResearch.com Interview with:

This photograph depicts a close-up of the lips of a patient with a herpes simplex lesion on the lower lip, due to the herpes simples virus-1 (HSV-1) CDC image

This photograph depicts a close-up of the lips of a patient with a herpes simplex lesion on the lower lip, due to the herpes simples virus-1 (HSV-1)
CDC image

Prof Ruth Itzhaki
Emeritus Professor
Division of Neuroscience & Experimental Psychology
The University of Manchester

MedicalResearch.com: What is the background for this study?

Response: The background arises from the unexpected discovery, made by my lab almost 30 years ago, that the DNA of the common virus, herpes simplex virus type 1 (HSV1), known as the “cold sore” virus, was present in a high proportion of autopsy brains from elderly humans. Subsequently, we found that HSV1, when in brain of people who have a specific genetic factor, APOE-e4, confers a strong risk of developing Alzheimer’s disease. We found also a parallelism with cold sores in that APOE-e4 is a risk for the sores, which occur in about 25-40% of people infected with HSV1.

We then looked for links between the effects of HSV1 infection of cells in culture and AD, and found some major associations between virus and disease.

Firstly, HSV1 causes an increase in the formation of a small protein called beta amyloid, which is the main component of the abnormal “plaques” seen in Alzheimer’s Disease brains.

Secondly, we discovered that in AD brains, the viral DNA is located precisely within amyloid plaques, which suggests that the virus is responsible for the formation of these abnormal structures. Thirdly, we confirmed the finding of another lab that HSV1 causes the increased formation of an abnormal form of the protein known as tau, which is the main component of the other characteristic abnormality of Alzheimer’s Disease brains – “neurofibrillary tangles”.

All these discoveries suggested that the damage caused by HSV1 leads eventually to the development of AD.

Lastly, we showed that treating HSV1-infected cells in culture greatly reduces the formation of beta amyloid and abnormal tau. This suggests that antiviral agents might be used for treating Alzheimer’s Disease patients.

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New SHINGRIX Vaccine Induces Stronger Immune Protection Against Shingles in Elderly

MedicalResearch.com Interview with:

Herpes Zoster or Shingles of chest Wikipedia

Herpes Zoster or Shingles of chest
Wikipedia

Anthony. L. Cunningham, MD
The Westmead Institute for Medical Research
Westmead, NSW
University of Sydney, Sydney,  

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This study examines the reasons why the HZ subunit vaccine candidate (HZ/su vaccine) consisting of a single viral protein, varicella-zoster glycoprotein E, and and adjuvant (immunostimulant) combination AS01B is so effective as a vaccine to prevent shingles (>90%), especially in those over the age of 70 years and 80 years, as published in recent trials i.e. it combats the declining immunity in the aging which usually restricts vaccine efficacy to under 60% in these age groups.  Continue reading

Shingles Can Occur At Chickenpox Vaccination Site in Healthy Children

MedicalResearch.com Interview with:

Depicted here, is a close-up of a maculopapular rash that was diagnosed as a crop of chickenpox lesions.

Depicted here, is a close-up of a maculopapular rash that was diagnosed as a crop of chickenpox lesions.
“Dew-drop on a rose petal pattern” CDC image

Hannah Song, BA
Medical studen
Harvard Medical School and
Jennifer T. Huang, MD
Division of Immunology, Dermatology Program
Boston Children’s Hospital
Boston, MA

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Infection with the varicella-zoster virus leads to chickenpox, or primary varicella. The virus then lies dormant and can later reactivate as shingles, or herpes zoster.  Varicella-zoster vaccine is made of an attenuated live virus that prevents most people from getting chicken pox, but rarely can reactivate and cause shingles.

There were several pediatric patients who presented to our clinics with shingles/herpes zoster that was localized to one extremity. My hunch was that the extremity where the patients had shingles could be the same limb where they had received vaccination. We called the patient’s pediatricians because pediatricians typically document the extremity where the vaccination is given, and confirmed the theory that shingles in vaccinated children may be more likely to occur at the site of vaccination. Importantly, vaccination may modify the classic appearance of shingles, and you might see pink and red papules and pseudovesicles, rather than classic grouped fluid-filled vesicles on a red base.  Continue reading

Nanoparticles From Pollution Can Awaken Dormant Herpes Viruses in Lungs

MedicalResearch.com Interview with:

Dr. Tobias Stöger Group Leader, Dynamics of Pulmonary Inflammation Comprehensive Pneumology Center Institute of Lung Biology and Disease (iLBD) Helmholtz Zentrum München

Dr. Tobias Stöger

Dr. Tobias Stöger
Group Leader, Dynamics of Pulmonary Inflammation
Comprehensive Pneumology Center
Institute of Lung Biology and Disease (iLBD)
Helmholtz Zentrum München 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Particulate air pollution is common in urban areas and the inhalation of nanoparticles is known to trigger inflammatory effects in humans potentially altering the immune system.

Herpes viruses are ubiquitous and well adapted pathogens hiding in host cells and persist thus continuing in a greater part of our population.

Under certain stress conditions and if the immune system becomes weakened, the viruses can become active again, begin to proliferate and destroy the host cell.

Thus we raised the question whether NP-exposure of persistently herpesvirus-infected cells as a second hit might provoke reactivation of latent virus and eventually lead to an inflammatory response and tissue damage.

Our main finding is that NP-exposure of persistently herpesvirus-infected cells – murine or human – restores molecular signatures found in acute virus infection and boosts production of lytic viral proteins.

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US Task Force Recommends Against Routine Screening for Herpes Simplex

MedicalResearch.com Interview with:

Ann Kurth, Ph.D., C.N.M., R.N.

Dr. Ann Kurth

 

MedicalResearch.com: What is the background for this study?  What are the main findings?

Genital herpes is a sexually transmitted infection that is caused by one of two subtypes of the herpes simplex virus (HSV-1 and HSV-2). The condition is common in the United States, as the CDC estimates that almost one in six people between the ages of 14 and 49 are afflicted.

Unfortunately, there are no good screening tests for herpes and it cannot be cured. After a systematic review of the evidence, the U.S. Preventive Services Task Force determined that, for adolescents and adults who have no signs or symptoms, including pregnant women, the harms of screening for genital herpes outweigh the benefits. These harms include high rates of false-positive screening tests, potential concerns around unnecessary antiviral medication use, and anxiety and relationship issues related to diagnosis. Additionally, the benefits of screening proved small, in part because early identification and treatment do not alter the course of the condition.

In the end, due to the lack of benefits in the face of serious harms, the Task Force recommended against routine serologic screening for genital herpes simplex virus (HSV) infection.

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Pubic Hair Grooming Linked To Increased Risk of STDs

MedicalResearch.com Interview with:

E. Charles Osterberg, M.D. Assistant Professor of Surgery Genitourinary Reconstruction and Trauma University of Texas- Dell Medical School Dell-Seton Medical Center / University Hospital

Dr. Osterberg

E. Charles Osterberg, M.D.
Assistant Professor of Surgery
Genitourinary Reconstruction and Trauma
University of Texas- Dell Medical School
Dell-Seton Medical Center / University Hospital

MedicalResearch.com: What is the background for this study?

Response: Pubic hair grooming has become an increasingly common practice among men and women. Perceptions of genital normalcy have changed as modern society’s definition of attractiveness and feelings of femininity and masculinity have changed. Pubic hair grooming has been shown to increase morbidity such as genital injuries, however little is known about the relationship between grooming practices and sexually transmitted infections.

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NYU Study To Evaluate Long-Term Treatment of Painful Shingles of the Eye

MedicalResearch.com Interview with:
Elisabeth J. Cohen, MD
NYU Langone Medical Center

MedicalResearch.com Editor’s note: Elisabeth J. Cohen, MD, of NYU Langone Medical Center, will head a five year study to evaluate new treatment protocols for herpes zoster ophthalmicus (HZO).
Herpes zoster ophthalmicus is a form of shingles that can cause prolonged pain and permanently damage the eye. Dr Cohen and NYU have received a grant from the National Institutes of Health to investigate the longer-term use of suppressive antiviral medication to reduce complications of HZO,

MedicalResearch.com: What is the background for this study? Can you tell us a little about herpes zoster/shingles?

Response: The rationale for the study is two-fold:

First: the accumulating evidence that zoster is followed by chronic active infection caused by the varicella zoster virus (VZV) that contributes to complications including vision threatening eye disease and life threatening stroke.

Second: the proven efficacy of suppressive antiviral treatment in reducing recurrent herpes simplex virus eye disease, caused by a different herpes virus, but with similar disease manifestations.

Zoster/shingles is caused by localized, unilateral reactivation of varicella zoster virus (VZV) in people who have had varicella/chicken pox resulting in a painful blistering rash that can be followed by chronic pain/postherpetic neuralgia. There are over one million new cases of zoster per year, and the incidence has increased over the past 6 decades for unknown reasons. Although the rate of zoster increases with age, the largest number of cases occur in people in their fifties.

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Little Known Herpes Virus Linked To Some Unexplained Fertility

MedicalResearch.com Interview with:

Roberta Rizzo PhD Department of Medical Sciences Section of Microbiology University of Ferrara Ferrara, Italy

Dr. Roberto Rizzo

Roberta Rizzo PhD
Department of Medical Sciences
Section of Microbiology
University of Ferrara
Ferrara, Italy

MedicalResearch.com: What is the background for this study?

Response: Infertility affects approximately 6% of 15-44 year old women or 1.5 million women in the US, according to the CDC. Approximately 25% of female infertility cases are unexplained, leaving women with few options other than expensive fertility treatments. Researchers are trying to identify factors and mechanisms at the basis of this condition.
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Ocular Herpes Zoster Can Be Chronic and Recurrent

MedicalResearch.com Interview with:
Kimberly D Tran, MD
Bascom Palmer Eye Institute

MedicalResearch.com: What is the background and purpose for this study? 

Dr. Tran: Approximately 30% of the population will suffer from herpes zoster (also known as shingles) at some point in their lifetime, with an estimated 1 million cases in the U.S. each year (1).  The most common long term complication of  herpes zoster is postherpetic neuralgia (PHN), or persistent neuropathic pain lasting beyond three months after initial presentation of  herpes zoster. PHN can negatively affect quality of life to a degree similar to congestive heart failure, depression, acute myocardial infarction,diabetes.

Postherpetic neuralgia is a leading cause of suicide in patients over 70 with chronic pain.(3,4) Of all the cases of herpes zoster, an estimated 10-20% will have herpes zoster ophthalmicus (HZO), which is defined as shingles in the area of the face near the eye, and sometimes the eye itself becomes involved.  Approximately 50% of individuals with HZO will develop ocular complications without antiviral treatment, while antiviral induction within the first 72 hours of rash onset reduces this number to 20-30% (2). Randomized control trial has demonstrated the efficacy antiviral therapy in the treatment of herpes zoster on first presentation.(6) What is less understood is the course of HZ after its initial presentation. Traditionally studied and treated in the acute phase,(5-7) recent data suggest that some patients experience a chronic or recurrent disease course. Based on this data, it is clear that more information is needed on the long term clinical course of herpes zoster ophthalmicus. The purpose of this study was to characterize the epidemiology of recurrent and chronic HZO in a unique South Florida population, with an ethnically and racially mixed, predominately male population.
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First Therapeutic Vaccine For Genital Herpes Shows Promise

MedicalResearch.com Interview with:

Zeena Y. Nawas, MD Clinical Research Fellow Center for Clinical Studies Houston, TX, 77004

Dr. Zeena Nawas

Zeena Y. Nawas, MD
Clinical Research Fellow
Center for Clinical Studies
Houston, TX, 77004

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Nawas: T cell immunity is believed to be particularly critical to the control of genital herpes, an incurable, lifelong sexually transmitted disease that affects roughly 500 million people worldwide. Genital herpes is characterized by recurrent, painful genital lesions and can be transmitted to sexual partners, even when there is no visible sign of the infection. Current genital herpes therapies only partially control the infection in some patients. These individuals continue to experience clinical symptoms and viral shedding, which drives disease transmission. Incomplete control of genital lesions and transmission risk, and the inconvenience of taking a daily medication are hurdles for effective long-term disease management.

GEN-003, is a first-in-class immunotherapy developed by Genocea Biosciences and is intended to treat genital herpes by inducing both a T cell and B cell (antibody) immune response. GEN-003 has demonstrated promising results to date by showing statistically significant reductions in the clinical signs of genital herpes and viral shedding, as well as safety and tolerability in its Phase 1/2 and Phase 2 clinical studies.

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Wrestlers Face High Risk of Skin Infections

MedicalResearch.com Interview with:

High School Wrestling Wikipedia

High School Wrestling
Wikipedia Image

Kurt Ashack
Fourth year medical student at Michigan State University, Michigan
Kyle Burton
University of Central Florida College of Medicine, Orlando, Florida

Medical Research: What is the background for this study? What are the main findings?

Response: Skin infections associated with high school athletics have been reported in literature since the late 20th century and while many skin infections are relatively minor, others can cause serious morbidity. Prior reports on skin infections among high school athletes have focused on specific sports or have evaluated relatively small numbers of athletes. No prior report has evaluated skin infections in a large national sample of United States (US) high school athletes across multiple sports.

During the study period, 474 skin infections were reported among 20,858,781 athlete exposures (AE); a rate of 2.27 infections per 100,000 AE. The largest number of skin infections occurred in wrestlers (73.6%), followed by boys’ football (17.9%) and boys’ basketball (1.9%). Baseball and swimming had much fewer cases. The most common infections were bacterial (60.6%), tinea (28.4%) and herpetic (5.2%) infections. Body parts most often affected were the head/face (25.3%), forearm (12.7%) and upper arm (8%). The average time for return to play was 3-6 days (45.5%). It was also interesting to note how many more infections there were in boys than girls. Girls’ volleyball had the most of girls’ sports, but all girl reports did not near the boy’s number.

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Ocular Herpes Can Rarely Occur After Varicella Vaccine

Frederick W. Fraunfelder, MD MBA Chairman and Roy E. Mason and Elizabeth Patee Mason Distinguished ProfessorDepartment of Ophthalmology Missouri University School of Medicine Director of the Missouri University Health Care’s Mason Eye Institute

Dr. Rick Fraunfelder

MedicalResearch.com Interview with:
Frederick W. Fraunfelder, MD MBA
Chairman and Roy E. Mason and Elizabeth Patee Mason Distinguished ProfessorDepartment of Ophthalmology
Missouri University School of Medicine
Director of the Missouri University Health Care’s Mason Eye Institute

Medical Research: What is the background for this study? What are the main findings?

Dr. Fraunfelder: The background starts with a paper by Hwang et al (Cornea. 2013 Apr;32(4):508-9.Reactivation of herpes zoster keratitis in an adult after varicella zoster vaccination. Hwang CW Jr1Steigleman WASaucedo-Sanchez ETuli SS.) After reading this paper, I started keeping track of keratitis cases that were reported to my registry (www.eyedrugregistry.com) and also to the FDA and WHO spontaneous reporting databases. We found case reports in adults and children of keratitis occurring soon after vaccination, and we presented this at the American Academy of Ophthalmology’s annual meeting that we just held in Las Vegas in November 2015.

The main findings are that in rare instances, relatively speaking, herpes infection can occur in the cornea of the eye within days to weeks after vaccination. This may especially be true in adults who have had shingles in the past which caused a keratitis in the past. This keratitis may reoccur after the vaccination, and primary care providers should inquire about this past medical/ocular history and advise of the risk of recurrent keratitis after the vaccination for shingles.

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Herpes Zoster/Shingles Vaccine Not Found Cost Effective In Patients Under 60

Phuc Le, Ph.D., M.P.H. Center for Value-Based Care Research, Medicine Institute Cleveland, OHMedicalResearch.com Interview with:
Phuc Le, Ph.D., M.P.H.
Center for Value-Based Care Research, Medicine Institute
Cleveland, OH 

Medical Research: What is the background for this study? What are the main findings?

Dr. Phuc Le: The live attenuated herpes zoster vaccine is approved by the FDA for persons aged 50 years and above. However, the Advisory Committee on Immunization Practices recommends it for only persons aged 60 years and older. Therefore, we aimed to analyze the vaccine’s cost-effectiveness among persons aged 50-59 years to see if ACIP’s recommendation is reasonable. We found that the vaccine is not cost-effective among people at aged 50 years, having an incremental costs of $323,000 per QALY gained, which is 3 times more than a commonly accepted threshold ($100,000/QALY).

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Tenovir Gel May Reduce Risk of Both HIV and Herpes Simplex

Dr. Salim Abdool Karim at CAPRISA Doris Duke Medical Research Institute South AfricaMedicalResearch.com Interview with:
Dr. Salim Abdool Karim at CAPRISA
Doris Duke Medical Research Institute
South Africa

Medical Research: What is the background for this study? What are the main findings?

Response: Globally, Herpes simplex virus type-2 (HSV-2) is among the most common sexually transmitted infections and is the leading cause of genital ulcers. Available global estimates indicate that approximately 417 million sexually active adults between the ages of 15 and 49 years had an existing prevalent HSV-2 infection in 2012. Current interventions to prevent HSV-2 infection, including condoms, circumcision, and antiviral treatment among heterosexual, HSV-2-discordant couples, have demonstrated protection levels ranging from 6% to 48%. This study showed that peri-coital tenofovir gel reduced HSV-2 acquisition in women by 51%, rising to 71% in high gel-users.

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Herpes Zoster Risk May Be Elevated In Psoriasis Patients On Combination Therapy

MedicalResearch.com Interview with:
Arnon D. Cohen, MD, MPH, PhD
Department of Quality Measurements and Research, Chief Physician’s Office, Clalit Health Services, Tel Aviv
Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

MedicalResearch: What is the background for this study?

Dr. Cohen: Herpes zoster (HZ), or shingles, is the consequence of reactivation of endogenous latent varicella zoster virus infection within the sensory ganglia. HZ is a major public health concern. It is a significant contributor of morbidity, disability, and chronic pain in the form of post-herpetic neuralgia.

The use of TNF-α inhibitors in rheumatoid arthritis and similar diseases and the risk for Herpes zoster has been assessed in several studies. However, the use of TNF-α inhibitors treatment in patients with psoriasis and the risk for Herpes zoster has been investigated to a lesser extent. Limited data is available regarding the association between the use of systemic medications or phototherapy and HZ in patients with psoriasis.

MedicalResearch: What are the main findings?

Dr. Cohen: Among 95,941 Clalit Health Services patients with psoriasis, 4,636 episodes of Herpes zoster were observed in a follow-up period of 11 years and 7 months. Monotherapy with biologic or systemic treatment was not associated with an increased risk for Herpes zoster. In a multivariate analysis, the use of combination treatment with biologic medications and methotrexate was significantly associated with an increased incidence of Herpes zoster.

MedicalResearch: What should clinicians and patients take away from your report?

Dr. Cohen: The present study demonstrates an increased risk for Herpes zoster among patients with psoriasis treated with combination treatment with biologic medications and methotrexate. Physicians may need to consider offering Herpes zoster preventive vaccine to patients receiving such treatments, particularly in the setting of additional risk factors for HZ.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Dr. Cohen: Future studies should focus on the use of Herpes zoster vaccine in patients with psoriasis who are treated with systemic or biologic medications.

Citation:

MedicalResearch.com Interview with: Arnon D. Cohen, MD, MPH, PhD (2015). Herpes Zoster Risk May Be Elevated In Psoriasis Patients On Combination Therapy 

Unvaccinated Children Have Higher Risk Of Developing Shingles

MedicalResearch.com Interview with:
Su-Ying Wen, MD
Chief of Department of Dermatology,
Taipei City Hospital, Renai Branch, Taipei City, Taiwan
Department of Dermatology, Taipei City Hospital, Renai Branch, Taipei City, Taiwan

Medical Research: What is the background for this study? What are the main findings?

Dr. Su-Ying Wen: Though herpes zoster is seen as a disease of the elderly, it can affect individuals in any age group including children. There are limited population-based data regarding pediatric herpes zoster.

We reported a higher incidence rate of pediatric herpes zoster than in previous studies. The higher incidence observed in this population-based study might be because it was measured in a cohort of children who were all infected with varicella rather than as other reports including individuals free of varicella infection in the denominator. Children younger than 2 years at the diagnosis of varicella had a significantly higher risk and shorter duration of developing herpes zoster. Continue reading

New Compound May Suppress Resistant Herpes Simplex

MedicalResearch.com Interview with:
Professors Lynda A. Morrison, Ph.D. and John E. Tavis, Ph.D.
Dept. of Molecular Microbiology and Immunology
Saint Louis University School of Medicine
St. Louis, MO 63104

Medical Research: What is the background for this study? What are the main findings?

Response: A number of viruses use enzymes in the nucleotidyl transferase superfamily (NTS) to carry out their genome replication. These enzymes include the RNaseH and integrase of HIV and the RNaseH of hepatitis B virus (HBV). Herpesviruses also encode proteins with functions that are consistent with NTS enzymes. We therefore tested compounds known or suspected to inhibit the HBV RNaseH for their capacity to reduce herpes simplex virus (HSV)-1 and HSV-2 in cell culture assays. We found that certain compounds from several different chemical families could inhibit HSV replication up to 1 million-fold, and were effective down to concentrations that are already in the same range as existing anti-herpesvirus drugs. Many of the same compounds that inhibited HSV-1 and HSV-2 also inhibited another human herpesvirus, cytomegalovirus. Importantly, we showed that these new inhibitory compounds have a different mechanism of action than acyclovir, a nucleoside analog that is the standard of care. In addition, the new compounds we identified could inhibit the replication of acyclovir-resistant HSV-1 and HSV-2.
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Study Aims To Predict Outcomes of Neonatal Herpes Simplex Infections

Ann J. Melvin MD, MPH Division of Pediatric Infectious Disease Department of Pediatrics Seattle Children's Hospital, Seattle, WA 98105.MedicalResearch.com Interview with:
Ann J. Melvin MD, MPH
Division of Pediatric Infectious Disease
Department of Pediatrics
Seattle Children’s Hospital, Seattle, WA 98105.

Medical Research: What is the background for this study? What are the main findings?

Dr. Melvin: While relatively uncommon, neonatal Herpes Simplex Virus is a potentially devastating infection with significant morbidity and mortality.  We reviewed all of the neonatal HSV cases treated at our institution between 1993 and 2012 who had HSV DNA PCR results available from the plasma and/or CSF.  Most of the infants had quantitative PCR results available.  The objective of the study was to determine the clinical correlation of HSV PCR levels in the plasma and CSF.  We found a clear association between the plasma HSV level, clinical presentation and mortality.  All of the infants who died had HSV plasma DNA levels of greater than 7 log10 copies/ml.   However, neither plasma nor CSF HSV levels predicted neurologic outcome.   Clinical evidence of CNS disease was more predictive of neurologic outcome than was the CSF PCR level. We also showed the most sensitive test for diagnosis of neonatal HSV to be HSV PCR on the plasma.  However, no single test diagnostic test (plasma PCR, CSF PCR, surface cultures) was positive across all infants, so it is important to obtain samples from plasma, CSF and surface swabs in infants with symptoms consistent with HSV infection.

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Shingles Vaccine Remains Effective, Even With Chemotherapy

Sara Tartof, PhD, MPH Post-doctoral research fellow Kaiser Permanente Southern California Department of Research & Evaluation.MedicalResearch.com Interview with:
Sara Tartof, PhD, MPH
Post-doctoral research fellow
Kaiser Permanente Southern California Department of Research & Evaluation.


Medical Research: What are the main findings of the study?

Dr. Tartof: Our study found that the herpes zoster vaccine continues to be effective in protecting older adults against shingles, even after they undergo chemotherapy. In particular, we found that those patients who were previously vaccinated with the vaccine were 42 percent less likely to develop shingles following chemotherapy treatment. We also found that none of our vaccinated patients underwent hospitalization for shingles, while six unvaccinated patients were hospitalized with the disease.
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Much of HIV Transmission Driven By Herpes Co-Infection

Dr. Don C. Des Jarlais PhD Director, International Research Core, Center for Drug Use and HIV Research Research Fellow, NDRI Director of Research, Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center Professor of Epidemiology, Department of Epidemiology and Population Health, Albert Einstein College of MedicineMedicalResearch Interview with:
Dr. Don C. Des Jarlais PhD
Director, International Research Core, Center for Drug Use and HIV Research
Research Fellow, NDRI
Director of Research, Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center
Professor of Epidemiology, Department of Epidemiology and Population Health, Albert Einstein College of Medicine

Medical Research: What are the main findings of the study?

Dr. Des Jarlais: HIV infection among non-injecting users of heroin and cocaine doubled doubled over the last several decades, from 7% to 14%. Herpes simplex virus type 2 (HSV-2) increases both susceptibility to and transmissibility of HIV. We examined HSV-2 infection among non-injecting heroin and cocaine user over the same time period using stored serum samples. HSV-2 infection was strongly related to HIV infection, and both increased over time. We calculated population attributable risk percentages (PAR%) to estimate the extent to which HSV-2 was driving increased HIV infection. HSV-2 infection was responsible for approximately half of the increase in HIV infection
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Oral HIV Prophylaxis May Also Provide Some Protection Against Herpes

Connie Celum, MD, MPH Professor of Global Health and Medicine Director, International Clinical Research Center University of Washington Harborview Medical Center Seattle WA  98104MedicalResearch.com: Interview with
Connie Celum, MD, MPH
Professor of Global Health and Medicine
Director, International Clinical Research Center
University of Washington
Harborview Medical Center
Seattle WA  98104

MedicalResearch: What are the main findings of the study?

Dr. Celum: We conducted a randomized, double blind study of daily oral tenofovir and tenofovir combined with emtricitabine (FTC) as oral pre-exposure prophylaxis (PrEP) for HIV among HIV serodiscordant couples (in which onepartner had HIV and the other partner did not) in Kenya and Uganda. Because of recent studies showing that tenofovir gel could reduce the chances of becoming HSV-2 infected, we studied the subset of HIV-uninfected partners who did not have HSV-2 and compared the rates who became HSV-2 infected during follow-up among those  who received oral pre-exposure prophylaxis versus those who received placebo.  We found that oral pre-exposure prophylaxis reduced HSV-2 acquisition by 30%.

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Pulmonary Fibrosis: Strongly Associated with a Herpes Virus

Gerard Nuovo MD Professor College of Medicine, The Ohio State University Satellite Laboratory, Ohio State Univ Comprehensive Cancer Center Phylogeny Inc, Powell, OhioMedicalResearch.com Interview with:
Gerard Nuovo MD
Professor College of Medicine, The Ohio State University
Satellite Laboratory, Ohio State Univ Comprehensive Cancer Center
Phylogeny Inc, Powell, Ohio

MedicalResearch.com: What are the main findings of the study?

Dr. Nuovo: The main finding of the study was that idiopathic pulmonary fibrosis was strongly associated with an infection by a herpesvirus.  The data that supported this main finding included:

  • 1) detection of the viral DNA by in situ hybridization in each case of idiopathic pulmonary fibrosis (IPF) and in none of the controls;
  • 2) the localization of the viral DNA to the nucleus of the cell that orchestrates IPF, the regenerating epithelial cell (herpes viruses localize to the nucleus of the target cell);
  • 3) the demonstration that the viral DNA co-localized with “pirated proteins” that the virus makes during productive infection (these were IL-17. cyclin D, dihydrofolate reductase, and thymidylate synthase); this combination of proteins are rarely if ever co-expressed in lung disease and  their co-expression per se was highly suggestive of a viral infection;
  • 4) the demonstration by RTPCR that the cyclin D RNA in IPF comes from the virus and not the human cells;
  • 5) the recognition that this family of herpesviruses (called gammaherpesvirus) causes IPF in other animals including horses, mice, and donkeys;
  • 6) the cloning of part of the gene of the virus from a clinical IPF sample that showed 100% homology to the published sequence of the likely viral pathogen – herpesvirus saimiri.
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