One-year anniversary

one year anniversary One year anniversary

For those of you who follow this blog with some regularity, I thought a quick post was in order to acknowledge that this blog site is approaching its first anniversary; the first blog post was made on June 15, 2013.  By June 14, 2014, the Herpesvaccine Blog will have been visited over 116,000 times.  Thank you one and all for your support.

From my perspective, perhaps the most notable / important utility of the Herpesvaccine blog has been in providing me with an initial outlet to help identify gaps in my own thinking and in my field of study that are important, but which are often not discussed in a clear and transparent manner in the scientific literature.

A case in point is my first full-length post on this blog entitled “Why don’t we have a HSV-2 vaccine yet?”  I opened this post with the following statements:

“The true definition of madness is repeating the same action, over and over, hoping for a different result.” – Albert Einstein

A common problem in science is that the natural world does not always conform to our initial expectations about how things “should work.”  In a nutshell, this is the primary problem that has plagued herpes simplex virus 2 (HSV-2) vaccine research for the past 40 years.  I elaborate below.

In this initial post I made a case that the primary reason we still lack an effective HSV-2 vaccine in the clinics is that, in essence, we have only seriously considered a single approach; namely, vaccines based on HSV-2’s glycoprotein D protein plus an adjuvant.  In contrast, a live-attenuated (replication-competent) HSV-2 vaccine has never been tested despite the success and safety of similar live-attenuated vaccines used to prevent smallpox, yellow fever, polio, mumps, measles, rubella, chickenpox, shingles, and rotavirus-induced diarrhea in small children.

Fast forward nearly a year.  My laboratory has just published a full-length, peer-reviewed article that makes this same argument, but in a much more complete manner and which cites over 200 published studies, hence offering the reader with my opinion on the important question of why we still lack a HSV-2 vaccine, but against the backdrop of the past 40 years of research and clinical literature on the topic.

The link to this June 2014 review of the status of HSV-2 vaccine research may be found here:  http://informahealthcare.com/doi/abs/10.1586/14760584.2014.910121

I close with the following text from the Prologue of the review, which summarizes the intended purpose of this new review of the HSV-2 vaccine research literature:

—————————————————————

PROLOGUE

“Herpes simplex virus 2 (HSV-2) vaccine reviews often provide an overview of which vaccine approaches have been considered in recent years [1,2]. The current review focuses on what I believe is a more pressing question: Why do promising HSV-2 vaccines keep failing in clinical trials [3–9]?  What doctors and the general public desire is a HSV-2 vaccine that works. What scientists desire is a better understanding of how to separate the wheat from the chaff when it comes to HSV-2 vaccines. The intention of this review is to consider such matters.

I hope to make plain that ‘antigenic breadth’ is a critical concept in HSV-2 vaccine efficacy, but has slipped under scientists’ radars for too long. Although vaccine scientists have been testing HSV-2 vaccines for three decades [10,11], the spread of HSV-2 genital herpes has not been slowed. Millions of our children will suffer the same fate unless we advance an effective HSV-2 vaccine into clinical trials posthaste.  The key questions are, ‘Is HSV-2 genital herpes a vaccine-preventable disease?,’ and if so then ‘Which HSV-2 vaccine approaches are most likely to achieve this goal?’ Against this backdrop, I discuss what I believe has gone awry with past HSV-2 vaccine strategies and consider what we might do differently in the future to improve our odds of success.

——————————————————————

It is my sincere hope that this review may help remind one or more academic scientists and/or vaccine industry leaders that, for better or worse, we are the individuals responsible for choosing which HSV-2 vaccine approaches will, or will not, be explored in the future.  The past decade of HSV-2 vaccine research has been fraught with disappointments and failure as we have done little more than pursue the status quo.  I sincerely hope that we collectively make better, and braver, choices in the next decade.

– Bill H.

button print gry20 One year anniversary

34 Responses to “One-year anniversary”

  1. lion May 18, 2014 at 10:39 am #

    I have been suffering from herpes for about 3 years now. There are days I feel as if there is a dark cloud over me that will never vanish. A vaccine would literally be a dream come true. I will not rest until there is a cure. We CAN cure it and we WILL!!

    • Bill Halford May 18, 2014 at 10:52 am #

      Thanks Lion,
      It is hard to overemphasize the importance of patient advocacy for their own cause. It reminds both scientists and those who fund science why a vaccine for HSV-2 genital herpes is important if they can hear such words that put a human voice and/or a human face behind the disease. Genital herpes is “no big deal” to people in the world who don’t realize that 1 of 6 of their friends are carriers of the HSV-2 virus. In contrast, people who know the score and understand how HSV-2 genital herpes can send their friends into a downward spiral of negative thoughts realize that this is potentially a big deal to people (millions of people), and it deserves our attention.

      Breast cancer and AIDS have rightly been pushed to the forefront of lawmakers and scientists’ minds by patient advocacy groups. Brief statements such as you offer above could help a larger percentage of lawmakers and scientists realize two important facts: (1) HSV-2 genital herpes is a big deal when it derails the life of someone you love like your son or your daughter; and (2) this is a vaccine-preventable disease. With just a little bit more attention and support from groups such as the Gates Foundation, we could solve this problem sooner rather than later and end this needless source of human suffering.

      – Bill H.

  2. Dante May 21, 2014 at 8:11 am #

    Hello Dr Bill.

    First of all congratulations about your website. You way of thinking truly should be heard by “the mans on the big chairs” and i’m certanly that your effort will really lead us, hsv sufferes, to beat this disease that some say “it’s no big deal”.

    About hsv, why some people have outbreaks all the time and some other folks dont feel a thing at all and spend even years without feeling an outbreak or experience mild simptons.
    It’ about the immunologic sistem or differents strains of the virus?

    Thanks’s Dr

    • Bill Halford May 24, 2014 at 1:29 pm #

      Hi Dante,

      Your question is basically “Why do some people who are HSV-2 infected have outbreaks all the time, whereas other HSV-2 infected individuals have no symptoms at all?”

      The simple answer is noone knows for sure, and thus what I write hereafter is speculative.

      I would guess that one major variable is the specific conditions of the primary infection. Some people may get infected with a large dose of HSV-2 that they are exposed to over the course of hours of sex (i.e., new couples often go at it several times in one night). Other people may be exposed to a lower dose of virus over a shorter period of time, so the efficiency of inoculating the cells in the epithelium of the vagina or the penis may be much lower. No two HSV-2 infections are exactly the same when you think through the details of how the virus is transmitted / contracted, and this variability in infection creates a lot of variability in how far the virus will spread before the immune system controls it. Moreover, if the person who contracts HSV-2 is anemic, run down through sleep deprivation, or on immunosuppressive medications, all of those factors will slow the immune response to the virus down…..hence allowing for more primary HSV-2 spread. The bottom line is that the extent of primary HSV-2 spread is a very important variable in dictating how heavily HSV-2 will seed the peripheral nerve fibers, and thus in dictating the “size of the reservoir latent HSV-2 DNA available” to support subsequent reactivation events.

      The second, less well understood variable is the “adaptive immune response to HSV-2.” This is a virus that encodes 75 HSV-2 proteins. There is nothing saying that the immune system of every single person who is HSV-2 infected responds to the virus with precisely the same populations of B-cells, CD4+ T-helper cells, CD8+ T-killer cells, and CD4+CD25+ T-regulatory cells. The simple reality is that the adaptive immune response to HSV-2 is very complex, and within this complexity may lie the answer of why some people mount an adaptive immune response to HSV-2 that is only “pseudo-protective.” That is, it “sees” and can eventually control HSV-2, but a pseudo-protective immune response to HSV-2 may be inefficient and days longer to intercept a HSV-2 reactivation event; that difference / delay of several days (relative to an efficient immune response) is enough to allow a HSV-2 reactivation event (a microscopic, single-cell event) to progress to a full-blown outbreak of genital herpes. In contrast, the adaptive immune response of an asymptomatic carrier of HSV-2 may have done a better job “learning” how to quickly recognize HSV-2 reactivation events (single-cell event) and thus “may head the virus off at the pass” and prevent reactivated HSV-2 from spreading to the point where an outbreak becomes visible (which typically takes 4 to 5 days after the initial reactivation event).

      There are other potential variables such as (3) virus strain variation and (4) host genetic variation. I cannot formally exclude these possibilities, but I will simply say that I find the evidence for these latter possibilities to be weak.

      Regarding possibility 3 (difference in HSV-2 strains), if there were certain “high reactivator” strains of HSV-2 circulating in the human population, then we should be able to find cohorts of people in certain towns or cities who all experience high levels of visible HSV-2 reactivation events (outbreaks) because these hypothetical “high reactivator” HSV-2 strains would be passed from person-to-person within a given town or city. However, the epidemiological data does not support / fit this hypothesis. Thus, I do not believe that differences in HSV-2 strain are a huge variable in controlling who gets frequent outbreaks of HSV-2.

      Regarding possibility 4 (difference in host susceptibility to HSV-2), differences in host genetic susceptibility have been hypothesized for the past century as explaining why some people get sick and others do not. However, after a century of investigating this hypothesis, there is no clear-cut evidence that this is a major factor in the human population. Certainly, there are serious genetic immunodeficiencies (scid, agammaglobunemia, stat1-deficiency, congenital neutropenia) that render people highly susceptible to infection to the point where their expected life span may drop from 75 years to less than 2 years. However, such immunodeficiencies are exceedingly rare (1 per million births?), and thus do not explain why some people get HSV-2 outbreaks and other carriers do not. I note that for almost ever infectious agent studies, there are a significant number of people who get asymptomatically infected whereas others experience disease. So, overall, I do not find the “host genetic susceptibility” hypothesis to be particularly compelling.

      So, I believe that the difference in HSV-2 infected people who experience asymptomatic infections versus those who have frequent outbreaks is largely controlled by the variables of (1) severity of primary infection / seeding of peripheral nervous system with latent HSV-2 during the first two weeks post-infection, and (2) the efficiency with which the adaptive immune response controls HSV-2 over the following years to decades. For reasons we do not completely understand, some carriers of HSV-2 mount adaptive immune responses (i.e., diverse populations of antibodies and T-cells that help the body “find” cells in which HSV-2 is actively replicating) that are very efficient at controlling HSV-2 reactivation events (single cell event) such that they never cause disease. For reasons that escape me (and apparently most investigators in my field of study), some individuals who carry HSV-2 seem to get stuck in a vicious cycle where there adaptive immune response to HSV-2 is only “pseudo-protective” and requires days to weeks to control a HSV-2 reactivation event…..hence allowing time for visible outbreaks of genital herpes to occur.

      – Bill H.

  3. John Raibley May 22, 2014 at 10:12 pm #

    Happy Anniversary Dr. Bill and a thousand thanks for all you do! JP

  4. Jonathan May 28, 2014 at 11:26 pm #

    Dr. Halford:

    Thank you so much for all of your work and the time you take to give such comprehensive answers tat are understood by the layman.

    Just one question related to your previous reply regarding severity of recurringHSV-2 infections:

    If lower recurrence (if there is any at all) or lesser severity of recurrances is dependent on the amount of latent reservoir initially established, do you believe that means that asymptomatic HSV-2 positive persons are -less- likely to transmit it to others? Obviously, asymptomatic persons can and do transmit the virus, but do you believe there may be a linear relationship between the frequency and severity of subsequent outbreaks (after the initial) by a seropositive individual and the level of virus that is shed by the them and hence, their propensity to infect an “average” person?

    Do you think that seropositives that exhibit no symptoms, take something like Valtrex daily, and always have protected sex, are extremely unlikely to transmit the virus? Like at the <1% annual level or even better? (I have heard that Valtrex+protection = 3/4 reduction in transmission propensity but nothing ever mentions how recurrence frequency or severity influences transmission risk)

    Thank you,

    Jon

    • Bill Halford May 29, 2014 at 7:43 pm #

      Hi Jon,

      At the end of the day, I am a science geek and not a real doctor. Hence, bear in mind that my answer really reflects my understanding of how HSV-1 and HSV-2 behave in animal models, and how I believe these findings translate to the human condition. Disclaimer, caveat, this is not medical advice, etc., etc.

      Having satisfied my legal / liability obligations, yes, I generally agree with the interpretation you offer. I believe that the words “asymptomatic carriers” are thrown around loosely in discussing patients and patient concerns, and I believe this creates needless confusion and an excessive amount of worry about the risks of asymptomatic HSV-2 shedding. My interpretation of what I have seen HSV-1 and HSV-2 do in the laboratory in animals, and what I have read in the literature about HSV-1 and HSV-2 in people, all seems highly consistent with the notion that (1) the severity of an individuals’ first exposure (primary infection) with HSV-1 or HSV-2 does indeed set the stage for (2) that person’s relative risk of experiencing a lifetime of episodic and symptomatic HSV-1 or HSV-2 recurrences. One of the logical reasons that this is the case (which is supported by extensive data in animal models) is that the severity of the primary infection is one of the main variables that influences how much latent HSV-1 or HSV-2 DNA will be seeded into neurons of the peripheral nervous system. So, simplistically speaking……..(1) severe primary HSV infection translates into huge reservoir of latent HSV DNA available to reactivate and drive recurrences later in life, whereas (2) an asymptomatic HSV infection that causes a person to become HSV-2-antibody positive but is too low level to produce symptoms of disease (i.e., 80% of HSV-2-infected people fall into this latter category) is probably going to be associated with a reservoir of latent HSV-2 DNA that is 10 to 100 times smaller (i.e., 1 to 10% of the latent HSV-2 DNA load of someone with recurrent genital herpes).

      The reason I re-visit these definitions is so that I may, in this paragraph, call attention to the problem with lumping all “asymptomatic HSV-2 shedding” together into one kettle. Let’s call the first group of HSV-2 infected persons who experience frequent recurrences of HSV-2 genital herpes “high reactivators.” These “high reactivators” may experience weeks to months of asymptomatic periods in between visible outbreaks. I believe what the literature clearly shows is that patients who are “high reactivators” always pose a risk to sexual partners regardless of their disease status, because they frequently shed infectious HSV-2 virus at their genital epithelium even when they are not having a visible outbreak.

      In contrast, I am unaware of any literature that meaningfully documents that people who are “HSV-2 antibody positive” but have never once had an outbreak of genital herpes disease pose the same risk to prospective sexual partners when they are also “asymptomatic.” Therefore, I believe that discussions of the relative risks of “asymptomatic shedding of HSV-2″ should be qualified to indicate whether we are talking about (1) high reactivator patients who (a) experience at least 2 outbreaks per year and (b) are in between outbreaks versus (2) persons who have serum antibodies against HSV-2 (i.e., are seropositive), but who have never had an outbreak of what they recognize as HSV-2 genital herpes. I don’t know what the relative levels of HSV-2 shedding would be from these two populations of patients, but everything I have seen in animal models would suggest that people who are HSV-2 seropositive but are fully asymptomatic likely shed 10- to 100-fold less HSV-2 than “high reactivators” during their asymptomatic periods between outbreaks.

      So, Jon, we come to your main question……..
      “Do you think that seropositives that exhibit no symptoms, take something like Valtrex daily, and always have protected sex, are extremely unlikely to transmit the virus?”

      My answer is yes, I think that such fully asymptomatic carriers of HSV-2 pose a low risk for HSV-2 transmission relative to persons who are in between outbreaks of HSV-2 genital herpes. However, unfortunately, I cannot quantify the relative risk and have not done the necessary studies to provide a real answer. Investigators at the University of Washington have done a lot of studies of asymptomatic HSV-2 shedding, but to the best of my knowledge most of this work focuses on patients with symptoms of HSV-2 genital herpes. Thus, I am not aware of any studies that quantify the relative risk for HSV-2 transmission that fully asymptomatic carriers of HSV-2 pose to their sexual contacts.

      If someone else knows more, please feel free to chime in as I have no doubt that there are others in this particular arena who are more knowledgeable than myself.

      – Bill H.

  5. yoshida June 7, 2014 at 11:50 pm #

    Hi Dr.
    Is is possible to locate the the reservoir of latent HSV DNA seeded in the neurons and surgically removed it?
    Thanks -

    • Bill Halford June 8, 2014 at 1:32 am #

      Hi Yoshida,

      That is a nice idea, but no it is not feasible. HSV-infected neurons look to our eye (even with a microscope) like any other neuron, so it would not be obvious which neurons are infected. Moreover, it is likely that in an average person with genital herpes, tens of thousands of neurons distributed through a variety of ganglia are latently infected, so this is not like removing a wart. Finally, the function of the peripheral nerves is pretty critical to your ability to feel and sense your surroundings. While I don’t think surgery could be used to cure herpes, the attempt to do so could leave a patient with chronic sensations of tingling and nerve pain due to tissue damage from the surgery. So, for a variety of reasons, surgery is not a viable solution to cure herpes.

      – Bill H.

  6. donaldo June 10, 2014 at 2:29 pm #

    Hi Dr Bill
    I know you have been asked this plenty of times but still, about the latest news on admedus or the corridon vaccine. I looked up the net and they said phase 1 is was completed and the vaccine seems to work. After phase 2 and 3 hopefully it will be in the market by 2015. Have they still produced any results or they are still yet to show anything. Don’t want to hear what the media says, i’d rather be informed by you as you are qualified. But being someone who is infected i hope they produce some remedy. As a matter of fact I hope any of them work.

    And about these vaccines, will they will stop the out breaks completely or will they just reduce the number outbreaks people have. I know it wont kill the virus but out of optimism and hope are there any vaccine that can kill it or at least stop it completely.

  7. vaccineistheonlyhope June 12, 2014 at 8:43 pm #

    donaldo, I do not think that the vaccine will come out that quick…2015 is way too soon, realistically maybe 2018-2020

  8. Needserenity June 16, 2014 at 2:38 pm #

    Dr. Halford,

    I am very interested in your research. I have just been diagnosed with HSV2. I would at the very least like to make a donation. Is this only possible by mail?

    Also, is there anything else that can be done volunteer wise to further your efforts?

    Thank you.

    • Bill Halford June 16, 2014 at 3:48 pm #

      Dear Needserenity,

      My university does have a mechanism to allow for online donations to the SIU Foundation, which represents the entire University (i.e., more than 25,000 students, staff, and faculty). To date, my experience tells me that while the SIU Foundation is very competent at taking people’s money, their track record at successfully identifying donations for the “Halford Vaccine Fund” is less than stellar.

      Thus, I can only assure that donations will successfully arrive in the Halford Vaccine Fund if they are addressed to my department’s business administrator, Risa Kirkpatrick, who is a consummate professional and makes sure that the donation arrives at the intended destination. The directions are below, and yes I am afraid the U.S. mail is the only option at this point in time.

      Many thanks in advance for supporting the cause!

      – Bill H.

      “Anyone interested in making a tax-deductible donation to the Halford Vaccine Research Program may do so by mail, as follows:

      Write a check payable to “SIU Foundation” and either in a letter or on the Memo line of the check write “Halford Vaccine Fund,” and mail the check to the following address:
      Mrs. Risa Kirkpatrick, Business Administrator
      Dept of Microbiology and Immunology
      Southern Illinois University School of Medicine
      P.O. Box 19626
      Springfield, IL 62794-9626

      These funds will be used solely for the purposes of HSV-2 vaccine research.

      Please note that while Online Donations to the SIU Foundation are technically possible, I can only personally assure that donations to the SIU Foundation are properly allocated into the Halford Vaccine Fund if they are mailed directly to my Departmental Business Administrator per the instructions above.”

      • JohnDJoe June 16, 2014 at 4:29 pm #

        Dr. Halford,

        you should maybe contact the SIU Foundation stuff, to enable the listing of your “Halford Vaccine Fund” under the priority School of Medicine.. so one can pick out School of Medicine > Halford Vaccine Fund as a donation priority.

        This would be much clearer then typing the same into Other Designations field.

        SIU-Foundation-Link:
        https://www.siuf.org/making-a-gift/give-online/

        • Bill Halford June 16, 2014 at 5:40 pm #

          Dear Joe,

          Great suggestion….thank you. I will look into this upon my return to Illinois next month.

          – Bill H.

  9. Michael June 18, 2014 at 8:59 pm #

    How about using an animal strain of herpes to vaccinate people, much like cow pox/small box. Many animals are also infected with herpes such as: dogs, horses, elephants, nonhuman primates, guinea pigs, tortoises, cattle, and cats.

  10. Mingyu June 22, 2014 at 12:46 pm #

    Congratulations, Bill!

    Great to see the blog has been doing so well, this blog has definitely an important venue to learn the herpes vaccine knowledge.

  11. Vladimir August 3, 2014 at 1:08 pm #

    Dr. Halford:

    A constant theme, and an appropriate one, is the discussion about the need for private funding to pursue an HSV-2 vaccine and possibly, a cure. It appears that this is so because of roadblocks to pursue a live virus-based approach in the government medical bureaucracy and very cautious US approval process.

    How much money -would- it require to fund your objective of developing and testing, through to the equivalent of Phase II trials? I would also ask if the most efficacious path would be to conduct the testing in the United States, or a country where the approval process for testing on humans in Phases I would be permitted – perhaps where there is a high HIV-prevalence and the discovery of an HSV-2 vaccine would actually help to reduce HIV infection rates.

    It is my belief that if there is a successful and well-run experiment to validate your approach in both mouse and simian animal models, and then a Phase-I equivalent test on safety, that there would be an enormous amount of pressure that could be brought to allow a Phase II and III in the US or Europe.

    How much would it take to get through the animal models, and how much to take through Phase I in a welcoming venue?

    Thank you,

    V

  12. care-bear August 10, 2014 at 3:05 am #

    Hello Dr. Halford,
    I have been suspecting HSV1 or 2 infections in my body for about 5 yrs. now. I believe I was infected by a man I was dating but never had intercourse with. I was not informed by him that he was positive but rather by a mutual friend once I had moved away and we were no longer together. I believe I had a couple of symptoms of an outbreak but at the time I was not considering HSV. Just thought it was a irritation or pimple. I had a couple more episodes over the next 3 yrs. Still didn’t immediately attribute it to HSV. I have never been tested. In the meantime I had gotten married and had 4 children. I began to have more severe OB after I had a tubal ligation in 2011. I have them on various parts of my body. When I have a visible symptom I go to the Dr. but I have yet to find a Dr. to corroborate or test. Most just say its a mild irritation and not classic HSV lesions and that testing is expensive and lengthy. They aren’t open to any other conversation on the topic. The last Dr. I went to I practically begged for Acyclovir. He gave it me but just to humor me I think. I suffer and wonder why is there no cure? I understand that there are worse diseases but to someone infected and who lives with the immeasurable fear of infecting loved ones daily or lingering seemingly never ending OB it is no less important. The urgency of this epidemic seems to fly under the radar and I for one cannot fathom why or how this happened. I have six children and I worry myself sick when I notice a bump and wonder if it could’ve been my fault and the guilt and shame becomes debilitating. If we can cure all the heinous diseases we have then how is there no focus on HSV? Please help us!? Not just for me but for the life of my babies. Will there be something more for people like me in the near future? Because frankly I just finished a round of Acyclovir and my symptoms have yet to subside. Should I try some of the other meds? Do they work differently or more effectively? Thank you for all you have and are doing. I will be making a donation. Thank you.

    • Visitor August 11, 2014 at 11:27 am #

      @care-bear
      You do not even know if it is HSV nor what is causing the symptoms. Prof. Halford can’t give you further insight on this topic, because he is a vaccine researcher and not a medical professional. You should visit a appropriate dermatologist.

      If you need further information or support for other HSV related stuff, you can visit http://www.herpes-coldsores.com/messageforum

    • Bill Halford August 11, 2014 at 1:27 pm #

      Dear Care-Bear,

      I agree with Visitor that the symptoms you describe are not a slam dunk for herpes. Not saying it is impossible, but I note that patients often arrive at a self-diagnosis of “herpes” simply because they are looking for a label to affix to their condition. I have on more than one occasion spoken with individuals who are (1) seronegative for HSV-1 and HSV-2 and (2) whose symptoms are not helped by acyclovir or valtrex, but who have come to believe they are infected with HSV-1 or HSV-2 despite the evidence I cite above that contradicts their conclusion.

      As “Visitor” correctly states, I am not a clinician. However, even from the other side of a computer monitor, I could appreciate why the doctors you have seen are reluctant to diagnose with you “herpes” when the presentation you describes does not fit, and acyclovir does not alleviate your symptoms.

      Autoimmune disease, allergies, eczema……? I have no idea what is driving your symptoms, but I think it is premature to worry about infecting your children with herpes when numerous physicians have effectively stated that this is not their diagnosis. It is one thing to be diagnosed with HSV-2 genital herpes, and continue sleeping with new people without warning them of the risks. It is another altogether to ignore the advice of doctors, arrive at a self-diagnosis of herpes, and then have a guilty conscience about spreading HSV-1 or HSV-2 viruses from skin irritations that may not be infectious in nature. Not sure how to help you, but I would suggest you consider the suggestion of past doctors that HSV-1 and/or HSV-2 may not be the underlying cause of your symptoms.

      – Bill H.

  13. care-bear August 12, 2014 at 3:37 am #

    @ Visitor and Bill,
    I am surprised @ this response and a little disappointed. First off I was not asking for any insight as a medical professional. I was only asking if Dr. Halford knew if these medications used for treating the symptoms of HSV worked differently from one another. He does mention them in some of his research and posts so I would assume he does or should if he was to bring them up. I have visited health professionals and they have stated that there is no “slam dunk” way that HSV presents so it can be hard to diagnose just by having a dermatologist look it over. Obviously, it can masquerade as other things like fissures. So basically I would have to have a test to know for sure. On the other hand I’ve had Dr.’s tell me if you have ever caught it (even as a child, as so much of the population has) and gotten even one small cold sore on your lip the test will be positive. Still, doesn’t mean that something else isn’t going on or contributing. So kind of a catch 22 there to begin with. I’m sorry I don’t have the money to pay for the test, and could barely afford the exam but obviously the physician didn’t think it was a bad idea to try the Acyclovir. Yet, I see that gives others the right to trivialize my experiences. I still think what Dr. Halford is doing is worthy of the Nobel Prize whether I have it or not. I just wanted to let him know. My children could most definitely along with the rest of us benefit from a vaccine whether they get it, have it or never get it from me or anyone else. I never said Acyclovir has never alleviated my symptoms but stated that this time for some reason wasn’t doing as great a job this time around. I will make sure next time I come here to comment I’m an “Officially tested and infected”.

    • Bill Halford August 12, 2014 at 8:17 am #

      Dear Care-Bear,

      My intent was not to make light of your experience, and I apologize that my words were not more carefully thought out so as to make that clear. A common mistake I see in medicine (i.e., I teach medical students) is that people often become fixated on one of several possible causes for a medical condition to the point where they forget to carefully consider each of the other alternatives. In your case, I am concerned that if you grow too fixated on herpes as the cause of your problem, you may miss other clues that could tell you it is something else and thus might miss out on a potentially simple solution. Both in medicine and in science, one of the greatest challenges is to remain open to the unknown and remain patient as you search for clarity and an answer. I hope you figure out the root of the problems you described in your first post.

      – Bill H.

  14. richard August 25, 2014 at 4:41 pm #

    Does taking daily medication over a long period of time reduce outbreaks after you stop taking the medication? I guess my thinking is if the meds prevent the virus from replicating, will the virus load inside of the body slowly lessen over time and ultimately lead to reduced or no outbreaks?

    • Bill Halford August 25, 2014 at 5:40 pm #

      Hi Richard,

      Probably the opposite is true. I would assume that as people take antiviral drugs, this should have no effect on the latent HSV DNA load in the body. However, antiviral drugs and the immune system perform the same job. Hence, logically speaking, as someone takes antiviral drugs daily, this should reduce the amount of viral protein / antigen in the body, and over time the HSV-specific immune response should contract. Thus, when someone has been taking antiviral drugs for months or years, I would assume that they should grow dependent on the antiviral drugs to hold back the virus…….so, even discontinuing the antiviral drugs for a few days would likely trigger an outbreak.

      The scenario I offer above is consistent with the published data in people and animals, and I note that several genital herpes sufferers have anecdotally noted to me that the tend to get hellacious outbreaks almost as soon as they discontinue their antiviral drugs. Maybe a few other blog readers can share their experiences and either (1) corroborate what I am saying or (2) indicate that they can discontinue their antiviral drugs for several weeks without any unexpected complications.

      – Bill H.

      • B September 25, 2014 at 11:37 pm #

        Hello Dr Halford,

        I contracted HSV 2 from my first sexual partner 14 years ago when I was 25 years old. My initial episode was extremely severe and, since then, I have experienced recurrent outbreaks (at least once a month, sometimes continuously) which leave me in excruciating neuropathic pain that does not resolve even after the sores have healed. After resisting suppressive antiviral therapy for many years, in 2009 I decided to try suppressive therapy with Valtrex. The medication reduced the frequency and severity of my outbreaks, and I was told by doctors that one day I would be able to come off it. Twice this year I have attempted to stop using the medication but within two days of stopping it, I experienced a severe outbreak and had to take it again. So, as you noted in your post, it appears that I have become dependent on this medication.

        Given the trauma, pain and loss caused by this tenacious virus over the past 14 years, I wait with much hope for the day when a HSV 2 vaccine becomes available.

  15. Visitor35 August 27, 2014 at 1:12 pm #

    Dear Dr. Hallford,

    I have a few questions as I am desperate for there to be a cure for this disease. I have not been diagnosed with this but I fear I may have it because I had a rash on my testicles that itched for about 7 days then it went away. I never witnessed any blisters or anything like that. I have had a similar rash before at some point after I had blood work once before but never thought anything about it because I would think i would have been told if something would have showed up. Anyways, on to my questions…

    First, do you think Dr. Ian Frazer’s newly researched work on hsv-2 shows great promise as a potential vaccine and cure? I read that it already passed human clinical trials with no side effects.

    Second, the literature on Dr. frazers vaccine seems specifically targeted to HSV-2, do you suspect that it will it would work for HSV-1 as well since both virus strains are so similar? If they could get this new vaccine for HsV-2 to work from that point would it be relatively simple to create another version that would treat HSV-1 if the vaccine Dr. Frazer is working on now is only targeted at HSV-2?

    Third, are there other companies working on an actual vaccine/cure? Or is it just more suppressive therapy stuff?

    It would be great if all of these pharmaceutical companies, including Dr. Ian Frazer, would put their heads and all their research together! We would probably have a major breakthrough very soon (maybe 3 -5 years) if all of these brilliant minds would not separate themselves with different companies and come together to solve this problem!

    Look forward to hearing from you. Have a great day!

    • Bill Halford August 27, 2014 at 1:30 pm #

      Dear Visitor35,

      If you think the rash on your testicles was caused by HSV-1 or HSV-2, then I would suggest having a physician order a blood test to determine if you have antibodies to either virus. That test alone won’t tell if you the rash was caused by either virus, but it seems hard to know how to proceed in your case if you don’t know your HSV-1 or HSV-2 infection status.

      – Bill H.

  16. Kris Matt September 27, 2014 at 1:02 am #

    I have been on acyclovir, Valcyclovir and Famcyclovir tablets for the past 3 years as and when I get the symptoms and it seems my cold sore case has worsened. Now even after taking the tablets the symptoms start appearing every alternate day of the course. (Redness and swelling)

  17. steve doyle October 24, 2014 at 8:26 pm #

    So i have hsv1 orally, and my conditions not too bad actually, i just get a small ob when im really sick. just a side note to my main question.. i had the tingling sensation for my first outbreak but i dont get that anymore, and as well, my cold sores never seem to fully develop? if that makes any sense at all. im guessing my adaptive immune response is just better now

    anyways, would the live attenuated vaccine be just a vaccine for people uninfected? or would it be a therapeautic “cure” or a full cure for those infected? i know youve probably mentioned this somewhere, and i dont mind if other people on here answer this, everyone seems reasonably smart on here lol

    and do you have herpes bill? just curious

    and i friggin hate disclosing it to a sexual partner, just did though and found out shes had cold sores since she was in grade 3 so i felt really relieved, i just hate the feeling of knowing that if you give it to someone, its for life.. i know its just a skin condition (mostly) but still its such a shitty feeling.

    and what time frame do you think we’ll see any significant vaccine or cure bill? like before 2020 ?

    oh and i have my undergrad in zoology, but virology seems really cool and id love to get into research

    it seems like only the states and ian frazer are the only places doing research for this? anything happening in europe?

    and if i ever win the lottery, definitely giving you like 2 mil for trials

    thanks so much for your time!

  18. steve doyle October 25, 2014 at 10:42 am #

    oh and why didnt they ever keep going with the indole 3 carbinol research?

    wouldnt it be possible to make a cheap i3c cream that could be applied daily and stop the virus from replicating at the surface? and eventually the virus would just die off?

  19. Roshan Durve October 26, 2014 at 12:24 pm #

    Dear Bill,

    Can you give me some information about the vaccine which Prof. Ian Fraser is developing? I had read around 15th October that phase 1 trials were successful and they managed to bring t cell response in 95% of people. Is this vaccine also for those already infected with HSV? Also will it completely cure herpes or just reduce the frequency and severity of outbreaks?

  20. Joanna Murchison November 11, 2014 at 6:32 am #

    I’ve just been diagnosed hsv1,2 I have no lesions just a little burning irritation when my menstrual is on, what does this mean? Do I have better chance of fighting this disease? I have puchased a lot of natural remedies and books will i intend on trying the protocols of all of them do u not recomend? All include special vitamins foods to avoid and products like 35% high grade, 100% olive oil and dsmo creams special diets and etc please help me determibe once and for all these remedies will not work or is it a possibility I can cure this virus completely out my body?

  21. Share Bear November 29, 2014 at 6:18 am #

    I had constant outbreaks with HSV2. Went on acyclovir for a year suppressive therapy. Worked great, no outbreaks, except one small one. I noted I still got constant “tingling” in the general area and slight redness and small swelling in the first outbreak area. After a year of suppressive therapy I stopped acyclovir for a time, constant outbreaks again, although not as bad. I started using apple cider vinegar externally every morning and every night. The “tingling” feeling slowly went away…. I have access to another years supply of acyclovir, but I’m using it as back-up when an unstoppable outbreak was to occur. Which has happened, I wont lie, but what gives me hope was the fact of its mildness. I have also noticed a numbing feeling in my lower spine, since the “tingling” feeling and outbreaks have virtually stopped? I’ve tried rubbing in Apple Cider Vinegar in that area as well, but I’m not sure it makes a difference. I’ve tried a lot of wacky online alternative stuff, but for me acyclovir and apple cider vinegar (natural which contains “mother” in it) are the real deal.

    Can anyone else back up the successful use of apple cider vinegar? Morning and night?

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