Antiviral therapy associated with fewer recurring eye problems from herpes simplex virus

ScienceDaily (Sep. 14, 2010) — Taking oral antiviral medications following infection with the herpes simplex virus may be associated with a reduced risk of recurring eye-related manifestations of the disease, according to a report in the September issue of Archives of Ophthalmology, one of the JAMA/Archives journals.

"Herpes simplex virus (HSV) is a common cause of corneal disease and is the leading infectious cause of corneal blindness among developed nations," the authors write as background information in the article. After the initial exposure to the virus and the resulting systemic infection, herpes simplex establishes a latent infection in sensory nerve structures. Reactivation of this latent infection could lead to initial or recurrent disease in one or both eyes, including inflammation or infection of the cornea, eyelid, membrane inside the eye (conjunctivitis, or pink eye) or middle layer of the eye (uveitis).

Ryan C. Young, B.A., of Mayo Clinic, Rochester, Minn., and colleagues estimated the incidence of HSV eye disease in a community-based cohort, in Olmstead County, Minnesota, from 1976 through 2007. During this time period, 394 patients with ocular HSV were identified, for an annual incidence of 11.8 per 100,000 individuals.

Oral antiviral therapy was prescribed in 175 (44 percent) of these patients, who underwent therapy for an average of 2.8 years (36 percent of the average 7.7 years of follow-up). Patients not taking this prophylactic therapy were 9.4 times more likely to have a recurrence of epithelial keratitis (infection of the top layer of the cornea), 8.4 times more likely to have a recurrence of stromal keratitis (infection of deeper layers of the cornea) and 34.5 times more likely to have a recurrence of blepharitis (eyelid infection) or conjunctivitis than those taking antiviral medications.

A total of 20 patients experienced adverse outcomes, including visual loss and perforation of the cornea; of these, 17 (85 percent) were not taking oral antiviral prophylaxis.

"Overall, this community-based retrospective study demonstrated a stable incidence of HSV eye disease during a recent 32-year period," the authors write. "We found a more dramatic protective effect of oral antiviral prophylaxis on recurrences of ocular HSV than had been described previously."

"The results of this study suggest that oral antiviral prophylaxis should be considered for patients with frequent recurrences of corneal disease," they conclude. "Additionally, we recommend an evaluation of the possible barriers preventing compliance with antiviral prophylaxis and a reassessment of the cost-effectiveness of long-term oral antiviral therapy."

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The above story is reprinted from materials provided by JAMA and Archives Journals.

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Journal Reference:

Ryan C. Young; David O. Hodge; Thomas J. Liesegang; Keith H. Baratz. Incidence, Recurrence, and Outcomes of Herpes Simplex Virus Eye Disease in Olmsted County, Minnesota, 1976-2007: The Effect of Oral Antiviral Prophylaxis. Arch Ophthalmol, 2010; 128 (9): 1178-1183 [link]

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Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

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Recurring genital problems could be herpes, Swedish study suggests

ScienceDaily (Apr. 11, 2011) — A study of patients attending sexual health clinics in Gothenburg found that just four out of ten patients with genital herpes actually knew that they had the disorder. However, a third of those who did not realise that they had been infected reported typical symptoms at a follow-up visit, reveals a thesis from the University of Gothenburg, Sweden.

In her thesis Matilda Berntsson, a specialist in skin and sexually transmitted infections at the Frölunda Specialist Hospital's skin clinic and researcher at the Sahlgrenska Academy, investigated the prevalence of genital herpes type 2 among patients attending sexual health clinics in Gothenburg. Her investigation included more than 1,000 patients, both male and female.

Genital herpes caused by herpes simplex virus type 2 infects the genital membranes before moving to the nerve ganglia alongside the spinal cord, where it remains for the rest of a patient's life. Although many people who have been infected do not experience any discomfort, the virus can be activated and spread further through sexual contact. The disorder can also result in recurring genital problems.

"1,014 patients who attended sexual health clinics, the Sahlgrenska University Hospital skin clinic and the Sesam sexual health clinic were tested for herpes simplex virus type 2," says Matilda Berntsson. "The presence of antibodies in the blood shows that a person is infected with the virus."

The test results revealed that more than one in five women and one in ten men were infected with genital herpes type 2. Just four out of ten patients with herpes type 2 antibodies actually knew that they were infected. However, a third of those patients who did not know that they were infected reported typical symptoms in the form of recurring genital blisters and sores at a follow-up visit.

"The study reinforces our perception that genital herpes is common and that most people carrying it are unaware that they have it," says Berntsson. "Non-specific recurring genital symptoms could be undiagnosed herpes, which can be detected with a simple test at the doctor's."

She therefore suggests that people with non-specific genital symptoms who are worried about genital herpes should see a doctor for an examination.

"If the symptoms and/or findings suggest herpes, there are good methods for testing for the disorder," says Berntsson. "Pronounced symptoms can be treated with medicines that alleviate discomfort, and a daily preventative treatment can be given for longer periods where recurrences are frequent."

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The above story is reprinted from materials provided by University of Gothenburg, via EurekAlert!, a service of AAAS.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

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Ambushed by recurring cold sores? Here's why

For such a ubiquitous plague, cold sores can be mighty shaming.

In addition to the indignity of wearing a bulging, weepy blister on your lip, sufferers also must contend with the stigma of its source: HSV-1, a type of herpes simplex virus.

But unlike HSV-2, the virus that usually causes genital herpes, cold sores are not usually sexually transmitted (though they can be). Most people get infected with HSV-1 as kids, from kissy adults.

"It is one of the most common viral infections, and yet you're a pariah," said Dr. Adam Friedman, director of dermatologic research at Albert Einstein College of Medicine at Yeshiva University in New York. "People look at you like you're a leper."

About 70 percent of Americans are infected with HSV-1, but just a third of those infected have cold sore outbreaks, said Bryan Cullen, professor in the department of molecular genetics and microbiology at Duke University Medical Center. Genetics likely separates the lucky from the unlucky, he said.

The hardy virus, which stays in your body your whole life, survives by moving up the sensory nerves after initial infection and vacationing in nerve bundles, where immune cells can't find and destroy it. Triggers such as stress, fatigue, sun exposure, picking at your lip or having a cold or the flu can reactivate some infected cells, which travel back to the initial infection site to cause a new outbreak.

There is no cure. Cullen and fellow researchers hope to find a way to disrupt the processes that keep the virus latent, so that they can coax it out of hiding all at once and ambush it with medication. But they're not close to clinical trials, Cullen said.

HSV-1 has been implicated in a number of diseases, including Alzheimer's, though that link is disputed. Though there are rare cases of severe complications from HSV-1 — such as when the virus spreads to the brain in immunocompromised people, causing death or neurological damage — for the most part "the worst part about (HSV-1) is probably the social stigma," Friedman said.

Prevention and treatment

Though the virus is most contagious during an outbreak, when the virus is "shedding," it's also possible to transmit when no outbreak is visible. According to a study published in 2008 in an oral medicine journal, at least 70 percent of people with HSV-1 shed asymptomatically at least once a month.

Friedman recommends keeping your mouth away from others when you feel a cold sore coming, during the outbreak and for a few days after it goes away. That includes oral sex, as HSV-1 can be transmitted from mouth to genitals (HSV-2 also can be transmitted from genitals to mouth).

Taking prescription antivirals such as acyclovir (Zovirax) or valacyclovir (Valtrex) can reduce healing time or prevent a blister from forming at all, clinical trials have shown. It's best to attack during the "prodrome" stage, when many people feel tingling or itching at the infection site, or have flulike symptoms, before a blister appears.

Friedman suggests applying ice at the first hint of a cold sore, holding it against the infected site for no more than 15 minutes, to reduce swelling. You might also soak a cotton ball in whole milk and hold it against the sore for 10 to 15 minutes daily, Friedman said. Milk contains the protein monocaprin, which can halt HSV-1.

Finally, cover a blister with a thick emollient such as petroleum jelly to speed healing and protect the wound from bacteria, Friedman said.

aelejalderuiz@tribune.com

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Recurring genital problems could be herpes, Swedish study suggests

ScienceDaily (Apr. 11, 2011) — A study of patients attending sexual health clinics in Gothenburg found that just four out of ten patients with genital herpes actually knew that they had the disorder. However, a third of those who did not realise that they had been infected reported typical symptoms at a follow-up visit, reveals a thesis from the University of Gothenburg, Sweden.

In her thesis Matilda Berntsson, a specialist in skin and sexually transmitted infections at the Frölunda Specialist Hospital's skin clinic and researcher at the Sahlgrenska Academy, investigated the prevalence of genital herpes type 2 among patients attending sexual health clinics in Gothenburg. Her investigation included more than 1,000 patients, both male and female.

Genital herpes caused by herpes simplex virus type 2 infects the genital membranes before moving to the nerve ganglia alongside the spinal cord, where it remains for the rest of a patient's life. Although many people who have been infected do not experience any discomfort, the virus can be activated and spread further through sexual contact. The disorder can also result in recurring genital problems.

"1,014 patients who attended sexual health clinics, the Sahlgrenska University Hospital skin clinic and the Sesam sexual health clinic were tested for herpes simplex virus type 2," says Matilda Berntsson. "The presence of antibodies in the blood shows that a person is infected with the virus."

The test results revealed that more than one in five women and one in ten men were infected with genital herpes type 2. Just four out of ten patients with herpes type 2 antibodies actually knew that they were infected. However, a third of those patients who did not know that they were infected reported typical symptoms in the form of recurring genital blisters and sores at a follow-up visit.

"The study reinforces our perception that genital herpes is common and that most people carrying it are unaware that they have it," says Berntsson. "Non-specific recurring genital symptoms could be undiagnosed herpes, which can be detected with a simple test at the doctor's."

She therefore suggests that people with non-specific genital symptoms who are worried about genital herpes should see a doctor for an examination.

"If the symptoms and/or findings suggest herpes, there are good methods for testing for the disorder," says Berntsson. "Pronounced symptoms can be treated with medicines that alleviate discomfort, and a daily preventative treatment can be given for longer periods where recurrences are frequent."

Share this story on Facebook, Twitter, and Google:

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Story Source:

The above story is reprinted from materials provided by University of Gothenburg, via EurekAlert!, a service of AAAS.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here