
Alzheimer's risk 10 times lower with herpes medication - subcosmos
https://www.medicalnewstoday.com/articles/322463.php
======
subcosmos
Right on the heals of the recent publication that shows that beta-amyloid in
the brain specifically wraps around HerpesViral particles in order to prevent
them from spreading!

[https://www.cell.com/neuron/fulltext/S0896-6273(18)30526-9](https://www.cell.com/neuron/fulltext/S0896-6273\(18\)30526-9)

Turns out, a great many viruses use low-density-lipoproteins (LDLs, of heart
disease fame) to travel around the body, and some even enter our cells by
binding to LDL receptors. The APOE gene, associated with alzheimers, binds and
transports herpes in the brain and hepatitis viruses in the liver!

[https://medium.com/@InfinoMe/cholesterol-have-we-shot-the-
me...](https://medium.com/@InfinoMe/cholesterol-have-we-shot-the-
messenger-a3f5dfeba09)

~~~
api
Umm... sooo... Alzheimers might be _viral_? Or is it just common mechanisms
that might be at work?

~~~
tyu100
No. The beta amyloid protein is the primary 'cause' of Alzheimer's. It builds
up in the brain and kills neurons and synapses. Tens of billions of dollars
have been spent developing drugs to reduce the amount of amyloid in the brain
to try and combat Alzheimer's, none of which has led to an effective
treatment.

This newer theory is that the cause of the amyloid build-up is an immune
response to the herpes virus increasingly infiltrating the brain (as you get
older the blood/brain barrier that protects your brain from infections
weakens) so a possible treatment is to try and reduce the levels of herpes
infection rather than attacking the amyloid protein which is your body's
immune response to the herpes infection.

The APOE4 gene is infamous for increasing amyloid production and being a major
risk factor for early-onset Alzheimers and so carriers of the gene are often
used in studies to see the effect of treatments. (@subcosmos below has a good
explanation of what this gene actually does)

~~~
subcosmos
The thing about viral infections of the nervous system is that you don't even
need to consider the blood brain barrier. Viruses travel backwards through
neurons by hijacking microtubule transport networks, and many groups have
hypothesized in the literature that it could be getting into the brain by
simply infecting a peripheral nerve and traveling up the spinal chord.

~~~
dnautics
> Viruses travel backwards through neurons by hijacking microtubule transport
> networks,

How does this help crossing the BBB? Can you give a citation?

~~~
subcosmos
Check out Figure 1 in this paper. The model effectively is that HSV infects a
great many people in early life, and becomes latent in neurons until old age.
Then it suddenly wakes up again and travels to the brain. All it takes is an
infected muscle or other tissue, allowing the virus to get into the nerve.
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3546524/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3546524/)

Some VERY notable statistics mentioned in the paper : "Such studies have
revealed endemic infection rates of 31% in children aged 6–14, rising to 49%
in adults aged 14–49, and to a high of 80–90% in the population over 65. In
one study of 40 autopsied TGs, HSV-1 sequences were amplified from DNA or RNA
extracted from 81% of TGs from demented subjects, and 74% of controls"

I blogged about these connections here, for I think that this retrograde
transport phenomenon might explain Tau phosphorylation, which is a secondary
hallmark of Alzheimer's and other dementias :
[https://medium.com/@InfinoMe/cholesterol-have-we-shot-the-
me...](https://medium.com/@InfinoMe/cholesterol-have-we-shot-the-
messenger-a3f5dfeba09)

~~~
dnautics
Nothing about the BBB in that paper.

~~~
pygy_
As its name implies, the blood brain barrier protects the brain from whatever
happens to flow in the blood stream. The herpes virus enters the brain by
another channel : the peripheral, somatosensory nerve cells whose axon has a T
shape. One prong of the top bar goes to the peripheral tissue, and the other
prong goes up to the brainstem.

~~~
dnautics
thanks for the explanation! That wasn't clear to someone who has enough
biochemistry and biology to be dangerous but with no experience in physiology.

~~~
pygy_
You're welcome!

Expanding further: the blood brain barrier is made of cytoplasmic expansions
of astrocytes in the central nervous system. The T-shape sensory cells are
part of the peripheral nervous system, their axon ends up in the encephalon.

------
credit_guy
Clickbait. The actual finding appears to be this: if you are diagnosed with
HSV (herpes simplex virus), your risk of dementia is 2.5 times higher. If
however, you get an aggressive antiviral treatment, then the risk is reduced
by a factor of 10. I take this to mean that overall, the risk do develop
dementia is 2.5/10 = 0.25 times the base risk, so overall, the Alzheimer's
risk is only 4 times lower with herpes medication, when compared with the
general population.

The relevant quotes from the article:

"The two groups were followed for almost a decade, between 2001 and 2010. In
the herpes group, the risk of dementia was over 2.5 times higher than in the
control group.

Significantly, the study also revealed that aggressive antiviral treatment
reduced the relative risk of dementia by 10 times."

~~~
carlmr
>I take this to mean that overall, the risk do develop dementia is 2.5/10 =
0.25 times the base risk, so overall, the Alzheimer's risk is only 4 times
lower with herpes medication, when compared with the general population.

Looking at Wikipedia "According to the World Health Organization 67% of the
world population under the age of 50 have HSV-1." and according to the source
there 11% have HSV-2. There's probably some good amount of overlap between the
two, but we have somewhere between 67 and 78% of the population with some form
of herpes. In any case the "general population" is closer to having herpes
than not having herpes, so we'd probably arrive at a factor somewhere closer
to the 10x.

~~~
credit_guy
In most cases that HSV-1 or HSV-2 is dormant, and the person is considered
healthy. In this study, the people diagnosed with HSV were considered sick,
and in some cases there was a need for the so-called "aggressive antiviral
therapy". Now, the study seems quite well conducted, there was a large enough
group of people diagnosed with HSV (about 8k people) and a control group of
about 25k people who were aged-matched with the first group, but healthy. The
two group were followed for 9 years. The main conclusion of the group, that
the people with HSV were 2.5 times more likely to develop dementia appears
sound, and the power of the experiment probably many times higher than the one
necessary to determine statistical significance. The secondary conclusion,
that the people "aggressively treated with antivirals" is not as strong, in my
opinion. First of all, it's not clear how many in the primary group were
subject to that treatment. In an extreme scenario, maybe we are talking only
about 50-100, in which case, we may end up with an intended or unintended case
of p-hacking. Second, the researchers may have looked for hundreds of things,
like how more prone to Alzheimer people who drank more alcohol were, or people
who watched too much TV, or other hypotheses. And we may end up again with
p-hacking (like in the acne-causing-green-jelly-beans xkcd [1]).

[1] [https://www.xkcd.com/882/](https://www.xkcd.com/882/)

------
jk27277
Interesting. Afaik Indians have a very low Alzheimer risk supposely because of
curcurma. My friend claimed curcuma also mildens Alzheimer syndromes. This
made me Google if curcuma helps against herpes. It does!

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2668156/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2668156/)

~~~
JohnJamesRambo
Curcumin is one of those compounds that does everything, that's not
necessarily a good thing, it is a hit in every assay. When you google
compounds and they are antifungal, antidiabetic, antibacterial, anticancer,
etc., it isn't a reason to get excited, they have no specificity.

Source: I work in natural products chemistry.

[https://en.wikipedia.org/wiki/Pan-
assay_interference_compoun...](https://en.wikipedia.org/wiki/Pan-
assay_interference_compounds)

[http://blogs.sciencemag.org/pipeline/archives/2017/01/12/cur...](http://blogs.sciencemag.org/pipeline/archives/2017/01/12/curcumin-
will-waste-your-time)

~~~
adrr
I also hate the term anticancer which gets tossed around a lot. Everything
that is toxic to human cells is anticancer which is what chemotherapy does. If
we found a substance that wasn't toxic to normal cells and killed cancer
cells, we'd have a safe cure for cancer.

~~~
1812Overture
Amazing health breakthrough! Our product Nature Farms Pure Organic Battery
Acid kills one hundred percent of cancer cells in lab tests!

~~~
subcosmos
Pure organic is great, but I won't use batteries unless they are vegan.

------
Angostura
I'm a mathematical illiterate (no really, and I'm not proud). The headline
hurts my head - does "risk 10 times lower" mean that there is one 10th of the
risk? so a 1 in 10 chance becomes 1 in 100?

~~~
Alex3917
> does "risk 10 times lower" mean that there is one 10th of the risk? so a 1
> in 10 chance becomes 1 in 100?

There’s no way to tell from reading the article, you’d need to read the paper.
From the article it’s not clear whether it’s the 2.5x increased risk that’s
decreased to 1.25x, or whether people on antiviral meds had a lower risk than
the control group (0.25x).

------
fauigerzigerk
I think it's worth noting that the herpes simplex patients were seeking
treatment for severe symptoms and were diagnosed using an antibody test. That
seems very unusual.

It wouldn't occur to me to see a doctor over a cold sore and if I did my GP
would probably laugh me out of the office.

So maybe (here's me grasping at straws) these people had herpes of a severity
completely unlike the millions that buy cold sore cream at the supermarket. Or
they had symptoms for the very first time, which would be extremely unsual as
well considering they were all over 50.

None of that takes away from the surprising effect of the anti-viral treatment
on Alzheimer's, but I think the size of the effect may be related to the
unusual severity of these particular herpes outbreaks.

~~~
findyoucef
You're being silly. I doubt your doctor would laugh you of the office for
requesting an HSV test. Now a days HSV testing combines type 1 & 2 into a
single test, so if you ever go in for STD testing you would get tested for
both. You don't have to have symptoms to go in for STD testing. You keep
everyone safer by being tested regularly despite the lack of symptoms. It's
not usual not to have HSV at that age, I'm 30 years old without HSV, and my
father who was in his 70s when he died had never contracted the virus either.

~~~
8f2ab37a-ed6c
Most STD panels do not include HSV tests though, you have to specifically ask
for those. Which is IMO a big part why 90% of people contracting HSV have no
idea they have it, in addition to simply being asymptomatic.

The typical set doctors look for are HIV, Syphilis, Gonorrhea and something
else that escapes me right now.

~~~
marvin
Probably Chlamydia. Can cause sterility and often doesn't have any obvious
symptoms.

------
kaycebasques
A few loosely related thoughts:

Background: HSV1 is commonly known as cold sores. Some people get them in
their mouth, or on their lips. Most of the population don't develop any
symptoms.

This link between HSV1 and Alzheimer's could be big business. The numbers are
wildly divergent, but it sounds like a sizable chunk of the US population has
HSV1. I've seen estimates from 20% to 80%. Even if it's the very conservative
20% number, that's still a big market.

The skeptic in me (his name is David) is suspicious of this article precisely
because it has the potential to be such a big market. Case in point, there's a
link to some HSV1 medicine at the bottom of the article. I wonder if they have
an affiliate marketing arrangement with the makers of acyclovir. Tangentially
related, I think that this article is on the front page of HN precisely
because HSV1 is so widespread. For example, if another article discussed a
cure for Alzheimer's, but that article involved some rare condition that does
not affect the general population, would that article hit page #1?

With that said, I think our society's lax approach to HSV1 is bizarre. In Sex
Ed, I didn't get any education around the fact that kissing people and sharing
drinks can spread a virus. After reading quite a few articles on the virus, I
got the impression that STD researchers don't really know much about it. I
could be wildly incorrect about that last point, I'm not a medical expert.
It's just the general impression I got when trying to understand HSV1 from an
STD perspective. For example, it's been common wisdom for a long time that, if
you have HSV1 (cold sores), then you can't get HSV2 (genital herpes). But the
reality seems to be more ambiguous than that. Apparently there was a fairly
recent study mentioning that college students who have HSV1 performed oral sex
on their partners and transferred HSV1 to the partner's genitals. Or something
like that.

Long story short, although I'm skeptical of the business incentives around
associating HSV1 with something as scary as Alzheimer's, I welcome more
research around understanding HSV1.

~~~
8f2ab37a-ed6c
Both types of HSVs supposedly have been with humanity for thousands of years
and are mostly asymptomatic or "occasionally unpleasant" as a condition, hence
the liberal attitude. When doing an STD screening, in the US at least, your
doctor will almost never bother with checking for HSV because 1. it's super
prevalent 2. it's not harmful with the exception of people with deeply
compromised immune systems

If you read about the history of the virus, supposedly in the past most people
figured they'd get it (both variations) sooner or later and didn't
particularly care. The stigma, especially of HSV2, allegedly started mid 20th
century when acyclovir / zovirax came on the market and the company who
created it needed a reason to push people to start using the medication.
Nobody wanted to at the time, as HSV wasn't a big deal. However once you call
people who have it "dirty" and make it shameful, the sales go up. Now you want
to suppress outbreaks and potential spreading at all costs. Similar to AIDS in
the 80s, in the US people won't even hug you if news leaks that you have HSV2.

Also amusing that, in the state of CA, receiving HSV (1 or 2) to the genitals
from someone of wealth is a great source of compensation. Most of the money
you'll receive from the civil case will not be for the medical treatment, it
will be because of the "psychological damages and impact to lifestyle" from
suddenly becoming a social pariah. Like you said, why this would be suable is
not obvious. If 80% of the population has HSV1 and you transmit it to the
genitals through oral sex, you're now a 2 year-long (statute of limitations)
juicy target for a lawsuit. People of means have lost millions of dollars to
this. Everybody having sex becomes a ticking timebomb of legal extortion.
Better have your partners sign a consent form.

~~~
findyoucef
Or tell people you have HSV1 before sleeping with them.

~~~
8f2ab37a-ed6c
Perhaps. Or perhaps something you can get a lip balm for at the Walgreens
checkout shouldn't cost you millions of dollars.

Also, if you do disclose, you better have in it writing. If there's no
evidence of STD disclosure, you can still be sued, and then it's he said vs
she said (or pick your permutation of genders) and it's your two reputations
competing for who's more trustworthy in court and can have the upper hand.
That disclosure can still cost you.

Lawyers will always advise you to have disclosure confirmation in writing
(email or paper is best, text might be still ok).

~~~
xenophonf
Lip balms do nothing to stop the spread of herpes, nor do they treat the
infection. At best they soothe the symptoms. The only OTC medication currently
available for cold sores, docosanol, seems to reduce the time it takes an
outbreak to heal, but there are questions about both its effectiveness and the
biological mechanism by which it works. The anti-viral acyclovir is also used
to treat cold sores as well as other forms of HSV, chickenpox, and shingles,
but it isn't available OTC.

------
eganist
I remember asking whether the HSV1/Alz link was a fringe theory based on the
lack of popular discussion around it
([https://news.ycombinator.com/item?id=17446016](https://news.ycombinator.com/item?id=17446016)).

As someone at hopefully an early enough age who hasn't had any (known? --
since there's never any certainty with it) outbreaks, I'm wondering whether
getting such a prescription based on family history at this point would be
well advised. It'd also be neat exploring the side effects and seeing if
that's a worthy trade, but it sounds like it probably is.

Biohacking is fun.

~~~
idbehold
23andMe says my risk of being diagnosed with Alzheimer's Disease during my
lifetime is 5.59x the average. There are few side effects that would make me
hesitate to try something like this to essentially reduce my risk back to
average.

~~~
godelski
> 23andMe says my risk of being diagnosed with Alzheimer's Disease during my
> lifetime is 5.59x the average.

Be careful with those numbers. I would neither fully trust it nor dismiss it.
But these genetic heritage companies have been known to get it wrong, a lot
(and very wrong in some cases).

~~~
yosito
From what I heard those genetic tests are about as accurate as saying "You
kinda look European and Europeans have a higher risk of Alzheimer's". Not
wrong, but also not a guarantee.

~~~
dumbmatter
That's not true, 23andme tests the APOE gene (and possibly some others too)
which does indeed have a large affect on the risk of developing Alzheimer's.

Although having the good version of APOE doesn't mean you'll never get it, and
having the bad version doesn't mean you're guaranteed to get it. The odds do
shift quite a bit, though.

~~~
DTND
>Although having the good version of APOE doesn't mean you'll never get it,
and having the bad version doesn't mean you're guaranteed to get it.

Well, having the bad version of the genes certainly doesn't guarantee anything
if you don't live long enough too. Only 5% of all people who have the disease
have developed symptoms before the age of 65 after all, while average life
expectancy of men in the US is at 76. It's very well likely to be predisposed
to diseases like these and not develop symptoms because something else killed
you before it could show up.

------
bitL
Is there any link between high heat and herpes? There was some sauna study
showing that people often doing sauna had significantly lower risk of
Alzheimer. Maybe herpes is flushed out by excessive heat and sweating or
rendered inefficient, even beyond blood-brain barrier?

~~~
blackkettle
Just a random guess, but I would hazard that it's not the heat. Going in a
properly hot sauna and 'soaking' for 15min or more gets you really sweating,
and increases your heart rate. Basically it 'gets your blood pumping', and
_probably_ produces an activity profile not too different from mild exercise;
and regular exercise has also been shown to consistently lower risk.

~~~
amelius
Could be, but I'd guess this works at the molecular level, with a set of genes
that is turned on/off in hot environments and producing some kind of desired
mechanism.

------
echelon
These developments are seriously exciting, and I can't wait for there to be
more studies done! If viral links turn out to be causal, then perhaps we have
a path towards a cure.

I wonder if there could be a link between HSV and the development of ADHD in
early childhood. Or perhaps other mental dysfunction?

~~~
echelon
(Too late to edit my own post.)

Furthermore, I wanted to add that there are a lot of studies that indicate
lack of sleep as a risk factor for Alzheimer's. Lack of sleep is also one of
the biggest causes of HSV reactivation and outbreak.

I'd be interested in knowing if Lysine supplements have similar effect to
acyclovir. The amino acid has a well studied suppressive effect [1, 2].

I'm going to email some of these authors to inquire.

[1]
[https://www.ncbi.nlm.nih.gov/m/pubmed/6262023/](https://www.ncbi.nlm.nih.gov/m/pubmed/6262023/)

[2]
[https://www.ncbi.nlm.nih.gov/m/pubmed/640102/](https://www.ncbi.nlm.nih.gov/m/pubmed/640102/)

------
dvfjsdhgfv
I tried to visit the website and a pop-up appeared trying to get my consent
re. tracking. Since I didn't agree, the website denied access displaying this
page: [https://anon.healthline.com/](https://anon.healthline.com/) I believe
NPR also uses the same tactics. How is this legal under GDPR? In any case, I
just disabled JS and read the article as usual. Moreover, I realized the web
(the document part, not the apps part) is actually so much better without JS.
Honestly, whenever JS is being used, it's almost exclusively against the user,
not to help them. This is from someone who is coding in JS for a living.

~~~
bryanrasmussen
The argument is that they need to do this particular tracking in order to make
their website work.

I believe this is against the GDPR, but need to make a complaint against them.

Arguments why it is against the GDPR, if you can display the text to a
googlebot and you will do no change to the structure of the document that is
the main purpose of coming to the site then it is not GDPR compliant to deny
someone access to the resource based on the argument that they need to do
tracking to make the particular resource work.

In other words they are quite clearly lying and should be fined.

There should be some general make GDPR complaint tool where people can go, say
where they are from, write what site complaining about, and it shows you
similar complaints for you to add yourself to, or to send a new complaint.
Then it packs them off to the relevant organizations to handle the complaint.
Probably someone has already made this tool but I don't know about it.

~~~
raverbashing
Maybe we should just change the browser referrer to googlebot's one

------
peacetreefrog
Did the people with the anti-virals take them immediately and upon getting
infected? Or did they just have to take them at some point post-infection?
Couldn't really tell from the article/not sure how the biology works.

~~~
kaycebasques
It’s not clear to me, either. Here’s my interpretation, based off the
abstract:

> These authors report that infection with a different herpes virus, herpes
> simplex virus type 1 (HSV1), leads to a similarly increased risk of later
> developing SD. Further, when the authors looked at patients treated
> aggressively with antiherpetic medications at the time, the relative risk of
> SD was reduced by a factor of 10. It should be stressed that no
> investigations were made on subjects already suffering from SD, and that
> those treated were the few rare cases severely affected by HSV. Nonetheless,
> antiherpetic medication prevented later SD development in 90% of their study
> group.

[https://content.iospress.com/articles/journal-of-
alzheimers-...](https://content.iospress.com/articles/journal-of-alzheimers-
disease/jad180266)

And the article:

> The latter study — deemed "most important" by Profs. Itzhaki and Lathe —
> examined 8,362 people aged 50 and above who received a diagnosis of herpes
> simplex virus (HSV) infection, as well as a control group of 25,086 age-
> matched healthy people.

Within the HSV1 population, a small amount happened to get aggressive
treatment at some point. It’s not clear whether they got treatment at any
point in their life, or if they got treatment after the study began (meaning
they got treatment at age 50 or later). This minority happened to have much
less chance of Alzheimer’s later on in life.

In regards to the timing of the treatment, my guess is that they got treated
upon outbreak, since it said that they were severely affected. They would get
treatment when they were in the most pain or discomfort.

It sounds like only a small minority of the 8K people in the HSV group got
treatment.

------
im3w1l
Apparently the virus in question is very common, most kids have it. So it
could be that Alzheimers indicates some immunodeficiency and that herpes
medication compensates for it.

Edit: I must have gotten confused. I was thinking they talked about HHV6/7 as
I saw another discussion about that recently
[https://news.ycombinator.com/item?id=17366591](https://news.ycombinator.com/item?id=17366591)
From another source: "Nearly 100% of humans are exposed to HHV-6 by the age of
three"

Edit 2: Although HSV 1 is also apparently very common in adults. 2 out of 3
have it.

~~~
eganist
There are other threads of research specifically pointing to HSV + ApoE4:
[https://scholar.google.com/scholar?q=hsv1+apoe4](https://scholar.google.com/scholar?q=hsv1+apoe4)

Results aren't consistent, but I would be surprised if the latest round of
texts didn't spur further examination.

------
noetic_techy
I'll add another link to the mix. Looks like all the drugs based solely on the
amyloid beta hypothesis have all failed:

[https://www.insidescience.org/news/Alzheimer%27s-Drug-
Trials...](https://www.insidescience.org/news/Alzheimer%27s-Drug-Trials-Keep-
Failing)

------
woodandsteel
There is this other theory, from what I understand, that Altzheimers is due to
the tau protein. I am wondering if that is true in some cases, and is due to
some sort of similar mechanism to the one the article is talking about. Or
maybe tau is getting dragged along when amyloid wraps around HSV particles.

------
known
Alzheimer's occurs due to a build-up of sticky proteins in the brain called
amyloid plaques;

And Scientists claim herpes, chlamydia and other infections could be
responsible for Alzheimer;

[https://www.netdoctor.co.uk/healthy-
living/wellbeing/news/a2...](https://www.netdoctor.co.uk/healthy-
living/wellbeing/news/a26239/could-the-cold-sore-virus-cause-dementia/)

~~~
noetic_techy
The amyloid beta theory is likely completely wrong. All drug trails so far
have failed:

[https://www.insidescience.org/news/Alzheimer%27s-Drug-
Trials...](https://www.insidescience.org/news/Alzheimer%27s-Drug-Trials-Keep-
Failing)

~~~
woodandsteel
But what this article seems to be indicating is that the drugs need to target
the HSV that the amyloid beta is wrapped around, not the amyloid beta itself.

~~~
subcosmos
Yup! And that targeting the beta-amyloid is a bad idea since it just allows
the virus to propagate again.

------
avaku
Ok, which medication?

