Study: New Way To Hold Back Herpes, Keep Virus Latent

Fluorescent staining shows areas of the cornea affected by herpes virus that infected a man's eyes. (Photo: Wikipedia)

Fluorescent staining shows areas of the cornea affected by herpes virus that infected a man’s eyes. (Source: Wikipedia)

Chances are, you’ve got herpes, I’ve got herpes, we’ve all got herpes.

Studies find that by age 60, virtually all adults carry herpes simplex virus 1 — best known for seeping cold sores but also potentially blinding when it hits the eyes. Herpes simplex virus 2, the sexually transmitted disease, infects more than a quarter of people by their forties, the CDC says.

While anti-viral medications can help, there is no cure for herpes viruses. Their wily ways of going latent between recurrences, hiding out in viral reservoirs in our bodies, make them supremely hard to eradicate.

So it’s welcome news that a study just out in the journal Science Translational Medicine describes a whole new strategy for beating down herpes viruses and keeping them down — at least in mice, rabbits and guinea pigs.

Far fewer of the mice died or had virus spreading throughout their bodies.

It’s a tactic that researchers say may also hold promise for attacking HIV, another virus whose habit of hiding out makes it hard to kill, and the herpes zoster virus that causes excruciating shingles.

The new method hinges on epigenetics — specifically, protein “packages” that determine how genes are turned off and on.

For a herpes virus to go from a latent state to an active state, it needs to unpackage or unbundle its genes so they can be “turned on” and begin to replicate and spread. But, the researchers found, if they block an enzyme called LSD1, those genes tend to stay bundled up and inactive.

It’s as if the viral DNA encoding the genes needed to reactivate the virus naturally carries a “Don’t open me!” sign on it, says the paper’s senior author, Dr. Thomas M. Kristie. The LSD1 enzyme can remove that sign. But block the enzyme and the “Don’t open me!” sign stays up. Continue reading

Confessions Of A Herpes Sufferer Turned Activist

Even though it’s a good bet that some of your best friends, neighbors and family members have herpes (overall prevalence by the time people reach their forties is 26%) it’s still a huge taboo.

It certainly was for Jenelle Marie, diagnosed with herpes 14 years ago and later, with a slew of other sexually transmitted diseases. In a new post on Our Bodies Our Blog, she describes the intense psychological stress of living with an STD and how, over time, as she learned the facts about her own condition, she overcame much of the social stigma. It wasn’t easy.

A lab image of herpes virus

A lab image of herpes virus

Here’s Marie on her initial diagnosis by a not-so-sympathetic doctor:

At 16, when our family doctor peered at me with a lazy eye, through thick glasses, and accompanied by a partially missing ear to tell me my genital herpes outbreak was the worst case he’d ever seen, I was devastated. Embarrassment coursed through me as he handed me a prescription and sent my mother and me on our way – sans brochures, additional information, and references to resources, support groups or even a mention of the vast number of people living with an STI everywhere. I was a pariah – a leper – even the doctor was disgusted by my condition.

For years, I accepted my fate and considered myself as being punished for having been sexually active before marriage. As a high-schooler, I was called a slut or a whore and “friends” of mine forewarned men who took interest in me that I would merely infect them, hurt them, and they should steer clear entirely. I actually maintained some of those friendships for a period of time, not knowing otherwise about STIs and those who contract them, thinking myself deserving of such treatment.

Now, she’s an activist, Continue reading

One Reader’s Response On Herpes: ‘Not Necessarily A Big Deal’

Boone historic archives

Please tune in to Radio Boston at 3 p.m. today to hear Dr. Lydia Shrier of Children’s Hospital Boston (and yours truly) talk about this recent post on how easily genital herpes can be spread.

During the taping, I found myself saying that I thought the takeaway message was double: “Be very, very careful, there’s a lot of this going around,” and also, “If you do catch it, you have a whole lot of company.”

One reader responded to the post with a consoling message that went one step further: If you do catch herpes, it’s not necessarily a big deal. At least, not for everyone.

True, herpes can cause pain, make people more susceptible to HIV and in rare cases, cause dangerous infections in newborns. Some people suffer through several outbreaks a year. But still, I thought the message-writer, Jeffrey Hunter, was making important points that are relevant to millions of people with herpes — and that might help offset the initial emotional pain that some may feel when first diagnosed. (And yes, he gave me permission to use his name.) Here’s his eloquent message in full:

I recently came across your article titled “Why You Should Assume Everyone Has Herpes” from a link on the npr.org website. I first off want to say thank you for bringing up the issue of how widespread herpes is. I don’t think most people are aware enough of just how common it is, how it is transmitted, or what the symptoms are.

There are a couple common assumptions about herpes, however, that I think we should be doing more to challenge. The first is that there is an automatic assumption that herpes is something really horrible to be avoided. I certainly won’t argue that herpes is good, but I felt your article was written from the point of view that contracting herpes must definitely be avoided, without actually examining that assumption. If in fact the prevalence among unmarried women between 45 and 50 is more than 50% in the country, at some point we have to ask, just how dire is this?

I myself tested positive for HSV-2 a little over a year ago. As you might imagine, that was a bit devastating to see on a test result, but after talking to my doctor about it and learning more about herpes I eventually found myself saying, if I have a virus which poses no long-term health risks and whose symptoms are so mild and infrequent that I would never have noticed them without a blood test to detect the virus, then just how serious is this? For myself I have to say, not very. Sure, it would be nice if I didn’t have the virus, and I certainly inform my partners about my status, but there are plenty of much more important health issues for me to spend my time worrying about (like, say, making sure my cholesterol levels remain healthy). Continue reading

12 Reasons To Assume Everyone Has Herpes

Responses rolling in to Friday’s post, “Why you should assume everyone has herpes,” have run the gamut from “Yikes!” to “Who cares?” But one common theme is surprise at how incredibly widespread and easy to catch genital herpes is, from “the statistics seem shocking” to “Wow, wish I had known this earlier.”

On the assumption that many people might benefit from getting word now rather than later, here’s a Cliff’s Notes version of Friday’s post, condensed for easier viral transmission:

1. New findings by a pre-eminent researcher on genital herpes highlight that even people who have never had herpes symptoms can “shed” quite a bit of virus and potentially infect others.

2. People with herpes who have never had symptoms shed virus on only about 10 percent of days, the study found. People who have had symptoms spread on about 20 percent of days. But both groups shed about the same amount of virus when they shed.

3. The researcher says that “asymptomatic transmission” may be the central way herpes is spread. In the old days, doctors warned mainly about spreading during an outbreak of sores or lesions.

4. Nearly one-fifth of the American adult population tests positive for genital herpes antibodies.

5. More than 80% of people with herpes don’t know they have it.

6. Overall prevalence by the time people reach their forties is 26%.

7. In the general population, one-fifth of women and 11.5% of men are infected.

8. Among single women between ages 45 and 50, the prevalence rate is between 50 and 70%. That’s according to North Carolina professor of medicine Peter Leone, speaking on NPR’s Science Friday. Continue reading

Why You Should Assume Everyone Has Herpes

A lab image of herpes virus

I’m sure my boyfriend doesn’t have herpes, a patient recently told Dr. Lydia Shrier, an adolescent medicine specialist at Children’s Hospital Boston.

How could she be so sure? Dr. Shrier asked. Because, the patient replied, she had scoped out his body and “there’s nothing irregular about him.”

Dr. Shrier, a researcher on sexually transmitted infections, goes through this kind of conversation all the time. Patients tell her that they’ve never had blisters or lesions or sores, and so cannot possibly have genital herpes. The same for their sexual partners.

It falls to her to disabuse them of these notions, saying: “You can have lesions or not, you can have symptoms or not, you should basically be operating the same way, which is to assume that everyone has herpes.” That means taking precautions, from limiting sexual contact to using condoms.

Dr. Lydia Shrier

Though this is her longstanding message, she now has better evidence to back it up than ever before. Last week, a pre-eminent researcher on the genital herpes virus, known as Herpes Simplex Virus 2 or HSV-2, published a landmark paper documenting the striking rate at which people with no herpes symptoms can nonetheless “shed virus,” potentially infecting partners.

The study, led by Dr. Anna Wald of the University of Washington, found that people who’d had symptoms of herpes shed virus on about 20 percent of days, while people who test positive for herpes antibodies but have never had symptoms shed virus on only about 10 percent of days.

But here’s the kicker: When they’re shedding, people who’ve never had symptoms shed roughly the same amount of virus as people who’ve had symptoms. So it’s clearer than ever that lack of symptoms is no guarantee against infection. And in fact, Dr. Wald said, “Asymptomatic shedding may be the central phenomenon of transmission.”

In the old days, doctors would warn herpes patients to avoid sexual contact mainly when they had active lesions, believing that was the only time they were really contagious.

But evidence has long been growing that herpes can be transmitted even when no lesions are visible. The new study, by quantifying how much virus is shed even in the absence of symptoms, “is a real ‘aha!’ moment,” said Fred Wyand, spokesman for the American Social Health Association. “It’s really robust in terms of the number of subjects they enrolled and the length of time they were followed,” he said.

The study also helps explain how genital herpes has become so wildly common, infecting nearly one-fifth of the American adult population, given that it’s hard to imagine many people would want sex while they had the painful nether-regions equivalent of cold sores. Consider this stunning fact from the American Social Health Association:

In the United States, more people have genital herpes than all other sexually transmitted infections combined -– 50 million people in total.

There are more mind-boggling statistics. Continue reading