{"id":1280,"date":"2017-04-11T15:48:02","date_gmt":"2017-04-11T14:48:02","guid":{"rendered":"https:\/\/blogs.bmj.com\/sti\/?p=1280"},"modified":"2017-04-11T15:48:02","modified_gmt":"2017-04-11T14:48:02","slug":"harms-of-hsv-2-may-include-association-of-latent-infection-with-autism-as-well-as-transfer-of-active-infection-to-the-neonate","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/sti\/2017\/04\/11\/harms-of-hsv-2-may-include-association-of-latent-infection-with-autism-as-well-as-transfer-of-active-infection-to-the-neonate\/","title":{"rendered":"Harms of HSV-2 may include association of latent infection with autism as well as transfer of active infection to the neonate"},"content":{"rendered":"<p><a href=\"http:\/\/msphere.asm.org\/content\/2\/1\/e00016-17\">Mahic &amp; Lipkin<\/a> (M&amp;L) draw attention to a wholly <em>new<\/em> health concern in relation to Herpes Simplex Virus 2.<\/p>\n<p>The condition is highly contagious, and the symptoms may be very unpleasant especially during the \u2018primary outbreak\u2019, the virus is not, in itself, a major public health concern.\u00a0 Indeed, up until the 1980s, it was rarely mentioned in this journal \u2013 perhaps because it was less common before the 1970s, or maybe because the condition was insufficiently severe to warrant much discussion.<\/p>\n<p>HSV-2 owes its status as a serious health problem to two issues that are independent of its impact on the everyday sufferers.\u00a0 The <em>first<\/em> concerns the potentially devastating consequences of transmission of HSV-2 to the neonate (generally in the course of birth rather than <em>in utero<\/em>) (<a href=\"http:\/\/sti.bmj.com\/content\/67\/1\/1\">Preventing neonatal herpes (STIs)<\/a>). \u00a0These are so severe as to have led to a considerable debate on the cost-effectiveness of screening in various parts of the world (<a href=\"http:\/\/sti.bmj.com\/content\/76\/4\/287\">Mindel &amp; Cunningham (STIs)<\/a> (Australia);\u00a0 <a href=\"http:\/\/sti.bmj.com\/content\/78\/6\/425\">Barnabas &amp; Garnett (STIs)<\/a> (US); <a href=\"http:\/\/sti.bmj.com\/content\/89\/7\/561\">Sudfeld &amp; Mensch (STIs)<\/a> (Malawi)).\u00a0 The <em>second<\/em> concerns the links between HSV infection and HIV transmission.\u00a0 This is an issue discussed primary in the sub-Saharan African context, where HSV is particularly prevalent and its treatment could potentially impact the HIV epidemic (<a href=\"http:\/\/sti.bmj.com\/content\/84\/Suppl_2\/ii12\">White and Glynn (STIs)<\/a>; <a href=\"http:\/\/sti.bmj.com\/content\/90\/8\/615\">Lurie &amp; Matthews (STI)<\/a>) \u2013 though also in the Indian context (<a href=\"http:\/\/sti.bmj.com\/content\/87\/1\/22\">Foss &amp; Watts (STI)<\/a>).<\/p>\n<p>To these <em>two<\/em> serious concerns <a href=\"http:\/\/msphere.asm.org\/content\/2\/1\/e00016-17\">Mahic &amp; Lipkin<\/a>, in a paper recently appearing in the microbiology journal <em>mSphere<\/em>, have added a <em>third<\/em> of as yet uncertain importance \u2013 the possibility of an association with male autism.\u00a0 Basing their investigation on data from the Norwegian Autism Birth Cohort (comprising mothers, fathers and infants recruited over the period 1999-2008), the researchers compared maternal immunoglobulin (IgG) antibodies to HSV-2 (amongst other viruses), which had been measured in 442 mothers of male offspring with ASD mid-term, against a frequency-matched control of 464 mothers of ASD unaffected offspring.\u00a0 An increase in HSV-2 IgG levels from 240 to 640 arbitrary units\/ml was found to be associated with a doubling (<strong>RR=2.07<\/strong>) in the odds of ASD.\u00a0 This was not replicated in the case of antibodies to other viruses that were tested for.<\/p>\n<p>The authors suggest that it is the \u2018impact of immune activation and inflammation on a vulnerable developing nervous system\u2019 which is likely to be the mechanism here rather than \u2018the specific pathogen <em>per se\u2019<\/em> \u2013 maybe the transfer of maternally produced antibodies and cytokines across the placenta, or the exposure of the fetus to inflammatory molecules produced by the placenta and deciduas in relation to viral shedding.<\/p>\n<p>The question posed by this outcome \u2013 should it be confirmed by subsequent research \u2013 is whether this third potential harm, when added to the well-established harm of neo-natal infection, might contribute to tipping the balance in favour serological monitoring and suppressive therapy during pregnancy \u2013 at least in certain contexts (cf. <a href=\"http:\/\/sti.bmj.com\/content\/78\/6\/425\">Barnabas &amp; Garnett (STIs)<\/a> (US)).<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Mahic &amp; Lipkin (M&amp;L) draw attention to a wholly new health concern in relation to Herpes Simplex Virus 2. The condition is highly contagious, and the symptoms may be very unpleasant especially during the \u2018primary outbreak\u2019, the virus is not, in itself, a major public health concern.\u00a0 Indeed, up until the 1980s, it was rarely [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/sti\/2017\/04\/11\/harms-of-hsv-2-may-include-association-of-latent-infection-with-autism-as-well-as-transfer-of-active-infection-to-the-neonate\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":152,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[16503,2273],"tags":[],"class_list":["post-1280","post","type-post","status-publish","format-standard","hentry","category-hsv-and-autism","category-hsv-2"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Harms of HSV-2 may include association of latent infection with autism as well as transfer of active infection to the neonate - Sexually Transmitted Infections<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/sti\/2017\/04\/11\/harms-of-hsv-2-may-include-association-of-latent-infection-with-autism-as-well-as-transfer-of-active-infection-to-the-neonate\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Harms of HSV-2 may include association of latent infection with autism as well as transfer of active infection to the neonate - Sexually Transmitted Infections\" \/>\n<meta property=\"og:description\" content=\"Mahic &amp; Lipkin (M&amp;L) draw attention to a wholly new health concern in relation to Herpes Simplex Virus 2. The condition is highly contagious, and the symptoms may be very unpleasant especially during the \u2018primary outbreak\u2019, the virus is not, in itself, a major public health concern.\u00a0 Indeed, up until the 1980s, it was rarely [...]Read More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/sti\/2017\/04\/11\/harms-of-hsv-2-may-include-association-of-latent-infection-with-autism-as-well-as-transfer-of-active-infection-to-the-neonate\/\" \/>\n<meta property=\"og:site_name\" content=\"Sexually Transmitted Infections\" \/>\n<meta property=\"article:published_time\" content=\"2017-04-11T14:48:02+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/sti\\\/2017\\\/04\\\/11\\\/harms-of-hsv-2-may-include-association-of-latent-infection-with-autism-as-well-as-transfer-of-active-infection-to-the-neonate\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/sti\\\/2017\\\/04\\\/11\\\/harms-of-hsv-2-may-include-association-of-latent-infection-with-autism-as-well-as-transfer-of-active-infection-to-the-neonate\\\/\"},\"author\":{\"name\":\"\",\"@id\":\"\"},\"headline\":\"Harms of HSV-2 may include association of latent infection with autism as well as transfer of active infection to the neonate\",\"datePublished\":\"2017-04-11T14:48:02+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/sti\\\/2017\\\/04\\\/11\\\/harms-of-hsv-2-may-include-association-of-latent-infection-with-autism-as-well-as-transfer-of-active-infection-to-the-neonate\\\/\"},\"wordCount\":496,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/sti\\\/#organization\"},\"articleSection\":[\"HSV and autism\",\"HSV-2\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/sti\\\/2017\\\/04\\\/11\\\/harms-of-hsv-2-may-include-association-of-latent-infection-with-autism-as-well-as-transfer-of-active-infection-to-the-neonate\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/sti\\\/2017\\\/04\\\/11\\\/harms-of-hsv-2-may-include-association-of-latent-infection-with-autism-as-well-as-transfer-of-active-infection-to-the-neonate\\\/\",\"name\":\"Harms of HSV-2 may include association of latent infection with autism as well as transfer of active infection to the neonate - 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