One-year anniversary


May 16, 2014 |

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.

one year anniversaryFast 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:

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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.

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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.

34 Responses to One-year anniversary

  1. 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?

  2. 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?

  3. 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?

  4. 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?

  5. 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!

  6. 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)

  7. 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.

  8. 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.

  9. 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!

  10. 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.

  11. 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?

  12. 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.

  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”.

  14. 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.