“They can cause chronic ailments”: MD - on the danger of herpes viruses

- Elena Valerievna, recently scientists managed to establish that modern variants of the herpes virus come from one ancient strain that arose about 4.5-5.5 thousand years ago.

At the same time, it is also believed that herpes accompanies people since the formation of our species.

Has herpes always been non-lethal for humans, or have we just adapted to each other over a long time?

- Herpes viruses are really very ancient, they exist as long as the human species, and maybe longer.

They are obligate (necessarily inherent) intracellular parasites, that is, they cannot reproduce their own kind without the help of host cells.

Herpes viruses cause disease not only in humans, but also in more ancient animal species - fish, birds, mammals.

The thesis that herpesviruses do not cause lethal diseases is not true.

Infection caused by herpes viruses can occur in various forms, including severe, lethal ones.

For example, encephalitis caused by the herpes simplex virus type 1 in young people and adolescents leads to severe neurological consequences or even death.

The range of clinical manifestations of herpes is very different: from asymptomatic or oligosymptomatic forms, such as a sore on the lip, which do not change the quality of our life, to extremely severe neurological lesions, autoimmune diseases.

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- According to WHO estimates, two-thirds of the world's population under the age of 50 are carriers of the herpes virus type 1. Up to 90% of the world's population is infected with the Epstein-Barr virus, and about 60% with cytomegalovirus.

What is the reason for such a high prevalence of herpes?

- The high prevalence of infection with the herpes virus is due to the fact that it uses almost all transmission routes.

This is also airborne, where the main factor is saliva, and, therefore, an uncovered sneeze means contamination with viruses within a radius of up to 7 meters.

This is a contact-household way, and sexual, and vertical.

The second point is that infection is assessed by the amount of antibodies in the blood of an individual.

Once in the human body, the herpes virus remains there in an inactive form forever.

At the same time, a person often does not suffer, since his body adequately develops an immune response and antibodies to this virus, which remain in the body as long as the virus is there.

Most people have antibodies to herpes viruses, up to 90-100%.

Another question is that herpes viruses are a classic opportunistic infection (from the English opportunity - opportunity), when the infection is in the human body and is waiting for an opportunity to cause a disease.

As soon as the body weakens, the virus will become active.

This is some of the danger of such a coexistence of man and the virus.

It is known that often the transmission of infection occurs vertically - from mothers to children.

If special therapy allows HIV-infected women to give birth to healthy children, are there similar methods for preventing children from becoming infected with herpes viruses?

- Each variant of herpes viruses has a “favorite” age of a person.

For example, the Epstein-Barr virus affects children in the first months of life only in isolated cases.

But the herpes simplex virus type 1 and cytomegalovirus often affect newborns and the fetus.

The varicella zoster virus (the causative agent of chickenpox.

.) can also infect the fetus, and at different stages of development.

The perinatal impact of human herpesvirus 6A/B is also discussed.

Doctors are ready for such a situation.

All obstetrician-gynecologists are fighting for the health of the baby.

A woman who has a herpes virus, especially its recurrent course, receives preventive treatment before pregnancy.

If pregnancy has already occurred, then it is possible to carry out safe treatment for both the fetus and the pregnant woman.

Now it is a routine practice.

Moreover, obstetricians-gynecologists convey information to pediatricians that the child was born from a mother with an infection who received (or did not receive) certain therapy and requires further monitoring.

I personally often observe such children in my practice, they can grow up healthy.

Only mothers need to remember that if an obstetrician-gynecologist has given a recommendation to contact a pediatrician with an outwardly absolutely healthy child, but a carrier of a herpes virus infection, then this must be done.

Infections such as cytomegalovirus can cause severe pathology in apparently healthy children up to the age of three.

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- Can herpes viruses become a hidden cause of weakened immunity, frequent illnesses - in children and the elderly, for example?

- Herpes viruses can really cause chronic ailments, or they can trigger the development of an autoimmune condition to which the patient is genetically predisposed.

The problem is that the conditions that cause herpes groups can present with non-specific symptoms.

For example, prolonged low-grade fever (a slight increase in temperature.

), headache, muscle pain, chronic fatigue syndrome, frequent respiratory diseases in children, incomprehensible enlargements of the liver and spleen, changes in the blood test - a long-term decrease in neutrophils.

All this can be associated not only with herpesvirus infection, but also with manifestations of other, non-communicable diseases.

When a person is examined and sees some markers in the analyzes, it is very important not to self-medicate, but to consult a specialist.

Because the diagnosis of herpesvirus infections, on which the nature of therapy depends, is quite complicated.

At the Central Research Institute of Epidemiology, we have developed methods that allow diagnosing active forms of herpes virus infection, they are used by the whole of Russia.

These are PCR diagnostics, virus DNA isolation and its quantitative determination in various media: saliva and oropharyngeal swabs, whole blood and plasma.

And only when the doctor confirmed that the human condition is connected precisely with the active virus, which continues to produce its own kind in the blood, antiviral treatment begins, which, as a rule, has an effect.

The detection of antibodies alone without additional research does not mean that the virus is active.

If it is not active, then the treatment for herpes, most likely, will not help.

In this case, it is necessary to look for another cause of the symptoms.

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- Previously, scientists from Harvard University found confirmation of the theory of the viral origin of multiple sclerosis.

In the studied sample of people, the risk of developing the disease increased by 32 times after infection with the Epstein-Barr virus.

There is also a version about the connection of herpes with Alzheimer's disease - it is assumed that the virus may be one of the factors causing this disease.

What is known about it today?

- Diseases such as multiple sclerosis and Alzheimer's disease are associated not only with the Epstein-Barr virus, but also with the human herpes virus 6A / B.

These virus variants can be a trigger that triggers processes in the body that lead to the development of multiple sclerosis, Alzheimer's disease, various forms of epilepsy, autoimmune thyroiditis - but only in those people who have a genetic predisposition to these diseases at a very subtle molecular level.

Research on the study of genetic predisposition to the development and severe course of various diseases has been carried out all over the world in recent years.

At TsNIIE, we have identified genotypes of children that predispose to the development of manifest (pronounced.

) forms of infection caused by the human herpes virus 6 A / B.

Even the replacement of a single nucleotide in the genes that encode proteins that protect against the virus can lead to serious consequences.

In this case, when infected with herpes, a severe disease develops with damage to the central nervous system, or the process of multiple sclerosis or Alzheimer's disease starts.

Outwardly, these genetic breakdowns do not manifest themselves in any way.

To identify unfavorable genotypes, it is necessary to conduct a complex laboratory study.

Now personalized medicine makes it possible to identify people who carry a defective gene and are at risk.

Such people should be periodically examined.

At the time of infection, even asymptomatic, it is important to immediately begin antiviral therapy in order to reduce the effect of the virus on the body.

But if multiple sclerosis, for example, has already begun, then at this stage the infectious disease specialist will no longer be able to help.

Viruses have already played their role, and in this situation it remains only to treat the underlying disease.

However, there are cases when antiviral therapy leads to a positive effect in children with convulsive syndrome or autism spectrum disorders diagnosed with an active form of herpes virus infection.

I can’t say that a child always fully recovers neurologically, but at least we are achieving some improvement in the condition: children begin to respond better to anticonvulsants, get sick with ARVI less often, which allows them to more actively carry out the neurological rehabilitation they need.

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Why can't herpes infections be cured?

“We, doctors, fundamentally disagree with such a formulation of the question.

Just imagine, a girl comes to an appointment with herpes on her face, which recurs every three weeks and makes it impossible to go to school, college.

And they say to her: it cannot be cured.

Well, how impossible?

After properly selected therapy, herpes begins to appear as a small sore on the lip every two years.

The girl already knows what medicine she needs to take so that herpes does not become a problem in her life.

Yes, herpes did not go away, but the quality of her life has changed dramatically.

We always tell patients: the herpes virus cannot be completely expelled from the body, but it is quite possible to coexist with it so that it does not interfere with a person's life.

- It was previously reported that a person suffering from the acute phase of herpes almost does not become infected with a coronavirus.

Is this true and what is the reason for this effect?

Indeed, such effects have been described.

Herpesvirus infection cannot prevent infection with coronavirus, but there is a phenomenon of viral interference (when, in response to a virus, the body begins to produce interferon, a protein that performs a protective function.

).

When an organism, already developing in itself the phase of one viral disease, when infected with another virus, cannot develop the disease that the second virus causes.

But the disease caused by the second virus may develop a little later, when the first virus has already “played out”.

Moreover, the coronavirus disease can create conditions for the transition of an inactive form of herpes infection into an exacerbation.

We very often see the activation of herpes virus infection after COVID-19 or simultaneously with it.

Or deterioration in the condition of patients after suffering COVID-19 associated with herpes reactivation, especially in children.

Therefore, the control of herpesviruses in post-COVID patients is very important.

If patients know that they once had a herpes infection, they should ask the doctor how they can prevent herpes flare-ups.

- In the United States, clinical trials of a vaccine against the Epstein-Barr virus have recently started - the drug was developed with the participation of the NIAID Vaccine Research Center.

Earlier, Moderna began testing an mRNA vaccine against the Epstein-Barr virus.

In Russia, a domestic vaccine against herpes types 1 and 2 is already being used.

Is it possible in the future to completely solve the problem of the spread of herpes through mass vaccination?

- No, it is impossible to solve the problems of herpesvirus infections by means of mass vaccination.

Because herpes is not an ordinary infection, it remains in the body for a long time, and infection with a number of such viruses occurs in childhood.

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The question arises: who and why to vaccinate - those who have not yet come into contact with the virus for prevention purposes, or those who are already infected so that the virus does not reactivate?

Vaccines do exist, but they are not immunoprophylaxis, but therapeutic vaccines.

They are shown to certain categories of the population.

There are patients for whom herpes poses a colossal life threat - in the case of immunodeficiency conditions, in particular after organ or bone marrow transplantation.

Immunosuppression allows the herpes virus to become aggravated and give the most severe generalized forms, requiring urgent, very complex antiviral therapy.

For such patients, vaccines are being developed so that their immunity can prevent the development of a serious illness caused by the herpes virus.

In Russia, there are vaccines against herpes simplex type 1 and recurrent genital herpes type 2.

But these are also therapeutic vaccines that stimulate T-cell immunity.

Often this is the only effective remedy against the recurrent course of herpes infection.

Such vaccines are used all over the world, but this is not a mass vaccination.

A therapeutic vaccine is an important therapeutic weapon, but not immunoprophylaxis.