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Herpes Simplex Virus 1 May Be Associated With Increased Risk For ...
October 30, 2023
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Key takeaways:Mounting evidence suggests that herpes simplex virus 1 may be associated with an increased risk for Alzheimer's disease and dementia, according to a systematic review of published studies.
"The underlying cause of Alzheimer's disease, a progressive neurologic disorder that is the most common cause of dementia, is poorly understood," Marc Cohen, BS, of the department of dermatology at the State University of New York, Downstate Medical Center, and colleagues wrote. "The neurotropic nature of [Herpes simplex virus 1 (HSV-1)], as well as its ability to establish dormancy in the sensory root ganglia of the trigeminal nerve, have made it a target of research as a potential infectious etiology for [Alzheimer's disease]."
Mounting evidence suggests that herpes simplex virus 1 may be associated with an increased risk for Alzheimer's disease and dementia. Image: Adobe Stock.To evaluate the epidemiological associations between HSV-1 and Alzheimer's disease, the authors conducted a systematic review consisting of 21 studies published between 1997 and 2021.
The evidence showed that there is an increased risk for Alzheimer's disease when HSV-1 is present in the brain vs. Controls (OR = 1.38; 95% CI, 1.14-1.66), according to a meta-analysis with a 4,353-person sample size. Another study with 3,566 subjects found similar results with an odds ratio of 1.4 (95% CI, 1.13-1.75) linking HSV-1 with the risk of Alzheimer's disease.
In a subgroup analysis, the presence of HSV-1 along with apolipoprotein E (APOE) epsilon 4 allele, a genetic variant known to be associated with an increased risk for Alzheimer's disease, was also found to increase a person's risk of contracting the disease by almost threefold compared with the presence of APOE epsilon 4 allele alone.
Many of the studies that the researchers evaluated, including one of the retrospective cohort studies of 33,448 subjects, showed that HSV-1 increased a person's risk for dementia, with two of the studies approximating a 2.5-fold risk increase compared with controls.
Further, in one of the studies including 265,172 subjects, antiviral treatment for HSV-1 was associated with decreased risk of dementia (HR = 0.89; 95% CI, 0.86-0.92).
"Recent studies demonstrate a strong correlation between HSV-1 and [Alzheimer's disease]; however, treatment of HSV-1 for prevention of [Alzheimer's disease] is not currently the standard of care," the authors wrote. "Due to the high prevalence of HSV-1 in the adult population, focusing on HSV-1 anti-viral suppression may be a reasonable course of action."
In their review, Cohen and colleagues concluded with a call to dermatologists to help in the "fight against Alzheimer's disease," as dermatologists may be at the frontline of HSV-1 treatment.
"Ultimately, understanding the connection between HSV-1 infection and neurodegenerative brain changes may become an integral part of the future of [Alzheimer's disease] prevention and treatment," they concluded.
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4 Best At-Home Herpes Tests - Medical News Today
Medical News Today Editor Lois Zoppi received a free herpes test kit from LetsGetChecked to review. All opinions are their own.
Use code "HEALTHLINE25" for 25% off
MNT's reviewThe LetsGetChecked home herpes blood tests can test for both HSV-1 and HSV-2. This test kit may be best for people who require regular testing, as the company's subscription options offer significant discounts.
A person receives a collection kit with all the tools they need to collect their samples at home. This includes needles, a prepaid envelope, alcohol swabs, and a tube. The tests come in discreet packaging so that other people will not know what the person has received.
The person can also access an instruction video on the company website explaining how to take their test. LetsGetChecked suggests that people take a blood sample before 9 a.M. And return it to the laboratory on the same day.
The company states that it issues the results within 2 to 5 days.
Individuals who receive a positive result can contact a nurse through the company who may suggest a treatment plan.
LetsGetChecked offers a one-time purchase for $119. Anyone who requires regular testing can purchase a subscription and get discounts on its tests. For instance, a 3-month subscription will give a person a 30% discount on the cost of the kits.
Learn more about LetsGetChecked.
What our tester says"I would recommend this product to MNT readers. It's an easily accessible way to access tests that allow you to gain insight into your health.
"I haven't used online health testing before, but I was really impressed by how simple the whole process was. Testing was easy and relatively pain-free, and my results came quickly.
"However, I would have liked more detail in my reports, and the cost of the tests is prohibitive for people on a tight budget."
— Lois Zoppi, MNT Editor
"I would recommend this product to MNT readers. It's an easily accessible way to access tests that allow you to gain insight into your health.
"I haven't used online health testing before, but I was really impressed by how simple the whole process was. Testing was easy and relatively pain-free, and my results came quickly.
"However, I would have liked more detail in my reports, and the cost of the tests is prohibitive for people on a tight budget."
— Lois Zoppi, MNT Editor
Pros & cons
People can order at-home herpes tests from MyLAB Box. These kits contain instructions, a specimen bag, and a prepaid return envelope. Users may find this test convenient because of its quick turnaround for results and the option to book a free consultation and get treatment.
It is also one of the more affordable tests available online.
Once a person receives their collection kit, they can collect their sample using the instructions. They can then use the prepaid envelope to send it to the laboratory.
People should receive their results within 2 to 5 days. If the test is positive, they can book a free consultation with a doctor to discuss their results and treatment options. The doctor may then prescribe treatment.
This at-home test only works for people who wish to test for genital herpes. The company does not offer test kits for oral herpes.
The kit costs $89 as a stand-alone test, but the company also markets other kits that test for different infections. For example, if a person also wishes to test for other STIs, they can purchase the Total Box – 14 Panel option or the Uber Box – 8 Panel option.
Read our in-depth review of myLAB Box.
Pros & consWomen-Founded
Women-Founded
STDCheck offers tests for both HSV-1 and HSV-2. A person can order an HSV-2 test for $45. There is also an option to order a test package that tests for 10 different STIs.
This option is best for people who need their results quickly.
To order a test, a person must enter their zip code on the company website to find their nearest testing center. The company claims it has over 4,500 test centers nationwide, making them a convenient option for most people.
A person needs to attend their local test center for a blood test. They should then receive their online results within 1 to 2 days. Anyone who receives a positive result is eligible for a phone consultation with an STDCheck doctor. The doctor may prescribe treatments at their discretion.
Pros & consPriority STD offers two lab-based herpes detection tests: A standard herpes test, costing $99, and a herpes early detection test, costing $189. The latter can detect the presence of the herpes simplex virus as early as 10 days after exposure.
This may be suitable for people who would prefer to seek swift diagnosis and treatment for herpes.
To order either herpes test, a person must access the company website and enter their zip code to find their nearest testing center.
The company claims it has over 4,000 private test centers across the United States.
After ordering the herpes test, a person can walk into their local center to receive the testing. An appointment is not necessary.
The test procedure involves a simple blood test and urine sample, typically taking minutes. A person can expect to receive their online test results within 1 to 3 days.
In the event of a positive result, a person can have a phone consultation with a partner physician, who may prescribe treatment at an additional cost of $65.
Pros & consThe table below compares the six at-home herpes tests for cost, follow-up care, and more.
Herpes is an infection with the herpes simplex virus (HSV). The virus spreads through contact with moist areas of the skin, such as the mouth and genitals.
HSV-1 causes oral herpes, which may develop after exposure to the virus in saliva or on skin surfaces. Some people develop the virus from nonsexual contact during childhood. Sometimes, HSV-1 can also cause genital herpes through oral sex.
HSV-2 causes genital herpes, an STI that affects more than 1 in 6 people ages 14–49 years in the United States.
People considering buying a home test may seek advice from a pharmacist on which test is likely to be best for them. The pharmacist may also be able to show them how to collect the sample at home to prevent inaccuracies.
People who are looking for an at-home herpes test should consider the following before making a purchase:
At-home and in-person tests screen for the herpes simplex virus and will return either a positive, negative, or inconclusive result.
At-home tests require a person to collect the sample themselves. These samples may include urine, mouth or genital swabs, or a blood sample.
While at-home tests may be more convenient for those uncomfortable discussing their sexual history with others or those who cannot easily access healthcare, there are some risks. If a person does not collect the sample correctly, they may receive an inconclusive or incorrect test result.
Some at-home tests involve ordering a test online and visiting a lab so that a technician can collect the sample. This may be a good middle ground between true at-home tests and tests from a clinic for those who prefer not to discuss their sexual health with their doctor.
Samples taken by lab technicians and healthcare professionals are more likely to be valid. These professionals have had training and are more likely to take the sample correctly.
Another difference between at-home and in-person tests is that companies offering at-home testing may not offer follow-up advice. On the other hand, healthcare professionals from a clinic can provide people with resources, treatment, and prevention tips.
The CDC recommends herpes testing only for people who experience symptoms. Herpes can produce blisters on and around the genitals, mouth, or rectum. One reason for this is that false-positive results are possible.
People who have active herpes lesions can undergo a swab test. However, if the lesion is small or has started healing, there might not be enough virus for the test to detect. Due to this, there is also a risk of a false-negative result.
Healthcare professionals may be able to diagnose a person with herpes if they present with blisters and sores. Doctors may also swab sores or blisters that have not yet healed and send the samples to a lab for tests.
Anyone who thinks they might have had exposure to HSV and wants to take a test for reassurance, despite a lack of symptoms, will need to test for antibodies in the blood instead. White blood cells produce antibodies when bacteria, viruses, or other unwanted substances. A positive antibody test may not indicate that a person has a current herpes infection. It also cannot tell people when they got herpes, if they have it.
According to the American Sexual Health Association, people should wait 12–16 weeks from the time of sexual contact before taking a test. The test checks whether or not the body has developed antibodies for HSV-1 or HSV-2, which may take some time to become detectable after exposure.
People who are sexually active or share needles with others may require regular testing.
Individuals with partners with herpes and who do not use barrier methods such as condoms each time they engage in sexual activity should also test for herpes regularly.
Some people may prefer to order their at-home tests from online providers since this does not require them to leave their homes.
A 2020 study notes that at-home kits may also benefit those who may not access routine healthcare.
There are two types of home tests: self-collection and laboratory-based.
Self-collection tests
After purchasing a test collection kit from an online provider, individuals receive all the tools they need to perform the test at home. They collect a sample by following the instructions in the kit and then return it to the company or its laboratory for analysis.
Laboratory-based tests
After purchasing the test from an online provider, the person receives a laboratory requisition form, which they present at a testing site. A healthcare professional takes the required sample, and the individual receives their result within a few days.
How accurate are at-home herpes tests?
At-home herpes testing may not be as accurate as in-person testing, but it may help you confirm if you have herpes. It's a good option for a patient who is unable to see an in-person physician or is hesitant to seek care from an in-person physician.
– Stacy A. Henigsman, DO.
HSV-1 or HSV-2 test results may be negative or positive. These results depend on the type of test people take.
False results can occur with many diagnostic herpes tests. Herpes tests are not as exact as tests for other STIs, such as chlamydia and gonorrhea.
A research review on the diagnosis of HSV-1 and HSV-2 concludes that using blood tests to diagnose genital herpes may be inappropriate because positive results may be due to chronic infection, whereas negative results may overlook recent infection.
Other factors that may determine the correct outcome of a herpes test result include sample preparation and the stage of infection of the sample.
Four types of tests can confirm the presence of the HSV-1 or HSV-2 infection. These are:
Polymerase chain reaction (PCR)
This is also known as a viral DNA test or HSV DNA test. The healthcare practitioner examines the sore sample to look for the DNA of HSV-1 and HSV-2 to determine which virus is causing the person's infection.
These tests are 99% accurate and represent the gold standard of testing by healthcare practitioners in advanced HIV infections.
Viral culture
A healthcare practitioner collects a sample from the person's skin sore and sends it to a laboratory to see if the virus grows. This type of test is useful early in an outbreak when the sore is open.
A positive result indicates that the person has an HSV infection. This may be an initial outbreak or a recurring one.
A negative result indicates that the test sample did not contain HSV. A negative result does not always mean that the person is free from the herpes virus. For example, a false negative may occur if the lesion is small or has started to heal.
Tzanck smear
A healthcare practitioner scrapes cells from the person's sore to look for characteristics of herpes infection. A clinician examines the cells at the doctor's office. There is no need to send the sample to a laboratory.
A positive result indicates the person has an infection. A negative result indicates that they do not have a herpes infection.
Antibody tests
Herpes simplex antibody tests determine the presence of the HSV-1 or HSV-2 virus. A clinician detects these antibodies in the person's blood or sore sample.
A positive result means that the person has HSV antibodies from a current infection or has had exposure, an outbreak, or infection. A negative result indicates that the person does not have the virus.
At-home herpes tests may be the preferred option for people who feel uncomfortable discussing their sexual health with a doctor and those who cannot visit a healthcare facility.
Many companies sell at-home tests. Before purchasing a test, an individual may wish to compare the costs, how long it takes the companies to issue the results, and their instructions for collecting the sample.
Some people may have difficulty collecting samples at home and interpreting the test results. Some companies may only offer consultations to individuals who receive a positive test.
There are different types of herpes tests a person may wish to take. People should consider that any test has room for error, and those who receive a positive herpes test result should contact a doctor to discuss treatment options or a follow-up test.
You Probably Have Herpes, But It's Probably No Big Deal
According to a recent report by the World Health Organization, 2 out of 3 people younger than 50 years old have Herpes Simplex Virus 1, or HSV-1, which is more commonly known as oral herpes. That's a staggering 3.7 billion people with an incurable virus.
But the thing about HSV-1 and HSV-2 — the "bad" herpes — is that they're very poorly understood by the general public, and even by some physicians. So if the headline above seemed shocking or offensive to you, we need to have a little chat. Because if you think that people with HSV are icky deviants covered in oozing sores, you've got a lot to learn — and you could very well be ignoring your own HSV status.
Here's what you need to know about the WHO's recent findings:
1. Yes, pretty much everyone has herpes — and more and more of it is genital.HSV-1 is known for causing cold sores — not "real" herpes, the STI that can cause sores around the genitals. This used to be pretty much true. In the past, most of the people who had HSV-1 got it as children, via dry smooches from infected aunties and the like.
But as people gained awareness of the contagious nature of cold sores, they became more cautious about exposing young children to a skin outbreak. That means more and more of us get to adulthood without any HSV immunity.
On the one hand, that makes the younger generation more susceptible to HSV-2 — one won't 100 percent protect you from contracting the other, but they have some antibodies in common. On the other hand, it means that more and more people get their first exposure to HSV-1 not through kissing, but through oral sex.
And even though HSV-1 prefers to live in mouths and HSV-2 prefers to live in genitals, they're capable of swapping neighborhoods in a pinch. So considerate young lovers with HSV-1 can unwittingly spread genital herpes.
Meanwhile, another 417 million folks in the same age group have HSV-2 itself. One study of New York City (from 2008) suggests that urban rates may be much higher: That survey found that more than 25 percent of the people they tested had HSV-2, with especially high rates for women (36 percent) and non-Hispanic black women (80 percent).
2. Anyone can get it.Herpes is a virus that's spread by skin-to-skin contact. Specifically, it's spread when a carrier sheds skin cells containing the virus and they come into contact with an opening in another's skin, either by way of a mucus membrane or an injury, however small. So even sex with a condom can spread herpes, though condom use does cut risk significantly.
Once herpes infects a new host, it travels along nerve cells to live dormant in their roots. For most HSV carriers, that's the end of the story. Most people with HSV never have any symptoms. If they do, they're often quite mild — tiny eruptions of the skin that could be mistaken for ingrown hairs. Cold sores and other herpetic blisters can be painful, and some HSV carriers will have frequent outbreaks, but this isn't the case for most people.
Unfortunately, the shedding of viral cells — and therefore the transmission of the disease to others — is possible even without symptoms.
The biggest concern is that HSV-2 and HIV have an unusual relationship, with one virus seemingly making it easier to contract the other. And those who are immunocompromised because of AIDS will obviously have an atypically unpleasant host of HSV symptoms. So avoiding HSV exposure is especially important for those with HIV and AIDS, and using condoms to avoid HIV exposure is incredibly important for those already diagnosed with HSV.
3. If you have it, you almost certainly don't know.Most physicians won't test for HSV unless a patient is exhibiting symptoms. If you've walked into an STI clinic and asked to be tested for "everything" — well, hate to break it to you, but HSV probably wasn't on the menu. In the previously mentioned New York study, 90 percent of HSV-2 positive patients had never had symptoms and never been tested.
4. People with HSV can keep their partners from getting it.Here's the good news: People with HSV-1 and HSV-2 don't have to be afraid of sex. Current research suggests that women with genital HSV who aren't having active outbreaks run a 4 percent risk of transmitting the virus to a male partner during intercourse.
Men carry a 10 percent risk of transmitting to a female. Condoms cut the risk in half. According to research, the use of daily antiviral therapy can cut the risk in half again, bringing it down to 1 percent and just over 2 percent, respectively. Needless to say, that's a pretty low risk.
There's less research on how easy it is to keep your oral HSV-1 from turning into someone else's genital HSV-1, but being honest with your partners, using protection, and avoiding contact during outbreaks is always a safe bet.
Originally Published: November 2, 2015 at 2:50 PM CST
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