The effects of daily distress and personality on genital HSV shedding and lesions in a randomized, double-blind, placebo-controlled, crossover trial of acyclovir in HSV-2 seropositive women

Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98101, United States.
Brain Behavior and Immunity (Impact Factor: 5.89). 06/2011; 25(7):1475-81. DOI: 10.1016/j.bbi.2011.06.003
Source: PubMed


Herpes simplex virus (HSV) infections are ubiquitous in humans, but the determinants of clinical and virologic severity are not completely understood. Prior research has suggested that psychological distress can be a co-factor in reactivation of latent HSV infection. Personality traits such as extraversion and neuroticism influence stress attributions and may inform the relationship between psychological distress and health outcomes. Earlier studies in this area have primarily focused on subjective reports of HSV lesion recurrence, but such reports may be influenced by both personality traits and distress. We report results from a randomized, double-blind, placebo-controlled, crossover trial of acyclovir in 19 women for whom personality was assessed at baseline and daily assessments of genital lesions, stress, anxiety, and depression levels were collected for 22 weeks. In addition, daily swabs of the genital mucosa were collected to assess HSV-2 viral reactivation. We found that daily stress predicted genital lesion frequency, and that daily stress, anxiety, and depression predicted genital lesion onset approximately 5 days before onset. Anxiety was also associated with genital lesions 3 days after onset. Distress and viral reactivation were not associated; and no personality traits were associated with any of the outcomes. These results support the hypothesis that psychological distress is both a cause and a consequence of genital lesion episodes.

Download full-text


Available from: Eric Strachan, Jan 07, 2014
  • Source
    • "However, low detection levels of ghrelin-reactive IgA in general do not support a functional role of such Ig in ghrelin signaling. The tentative correlation between ghrelinreactive IgM and anti-HSV-2 antibodies would be in line with a study that found increased anxiety shortly after HSV-2 virus reactivation (Strachan et al., 2011). However, this correlation was weak, and hence, might also be a chance finding. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Ghrelin, a hunger hormone, has been implicated in the regulation of stress-response, anxiety and depression. Ghrelin-reactive immunoglobulins (Ig) were recently identified in healthy and obese humans showing abilities to increase ghrelin's stability and orexigenic effects. Here we studied if ghrelin-reactive Ig are associated with anxiety and depression and with the stress-induced cortisol response in a general population of adolescents. Furthermore, to test the possible infectious origin of ghrelin-reactive Ig, their levels were compared with serum IgG against common viruses. Methods: We measured ghrelin-reactive IgM, IgG and IgA in serum samples of 1199 adolescents from the Dutch TRAILS study and tested their associations with 1) anxiety and depression symptoms assessed with the Youth Self-Report, 2) stress-induced salivary cortisol levels and 3) IgG against human herpesvirus 1, 2, 4 and 6 and Influenza A and B viruses. Results: Ghrelin-reactive IgM and IgG correlated positively with levels of antibodies against Influenza A virus. Ghrelin-reactive IgM correlated negatively with antibodies against Influenza B virus. Ghrelin-reactive IgM correlated positively with anxiety scores in girls and ghrelin-reactive IgG correlated with stress-induced cortisol secretion, but these associations were weak and not significant after correction for multiple testing. Conclusion: These data indicate that production of ghrelin-reactive autoantibodies could be influenced by viral infections. Serum levels of ghrelin-reactive autoantibodies probably do not play a role in regulating anxiety, depression and the stress-response in adolescents from the general population.
    Full-text · Article · Jan 2015 · Progress in Neuro-Psychopharmacology and Biological Psychiatry
  • Source
    • "s , at present , the most likely explanation for elevated CMV - IgG levels in distressed individuals ( Glaser and Kiecolt - Gla - ser , 1994 ; Kuo et al . , 2008 ) . Longitudinal studies linking temporal changes in mood and distress with fluctuation in CMV - IgG may further corroborate this idea ( Faulkner and Smith , 2009 ; Stowe et al . , 2007 ; Strachan et al . , 2011 ) . The results showed that the association between CMV - IgG and psychological stress was strongest in low - SES individuals ( job status , education ) , and virtually absent in high - SES employees . While previous studies have singularly explored a possible stress - CMV or a SES - CMV association , our investigation is the first to p"
    [Show abstract] [Hide abstract]
    ABSTRACT: Cytomegalovirus (CMV) is a herpes virus that has been implicated in biological aging and impaired health. Evidence, largely accrued from small-scale studies involving select populations, suggests that stress may promote non-clinical reactivation of this virus. However, absent is evidence from larger studies, which allow better statistical adjustment for confounding and mediating factors, in more representative samples. The present study involved a large occupational cohort (n=887, mean age=44, 88% male). Questionnaires assessed psychological (i.e., depression, anxiety, vital exhaustion, SF-12 mental health), demographic, socioeconomic (SES), and lifestyle variables. Plasma samples were analyzed for both the presence and level of CMV-specific IgG antibodies (CMV-IgG), used as markers for infection status and viral reactivation, respectively. Also assessed were potential biological mediators of stress-induced reactivation, such as inflammation (C-reactive protein) and HPA function (awakening and diurnal cortisol). Predictors of CMV infection and CMV-IgG among the infected individuals were analysed using logistic and linear regression analyses, respectively. Confirming prior reports, lower SES (education and job status) was positively associated with infection status. Among those infected (N=329), higher CMV-IgG were associated with increased anxiety (β=.14, p<.05), depression (β=.11, p=.06), vital exhaustion (β=.14, p<.05), and decreased SF-12 mental health (β=-.14, p<.05), adjusting for a range of potential confounders. Exploratory analyses showed that these associations were generally stronger in low SES individuals. We found no evidence that elevated inflammation or HPA-function mediated any of the associations. In the largest study to date, we established associations between CMV-IgG levels and multiple indicators of psychological stress. These results demonstrate the robustness of prior findings, and extend these to a general working population. We propose that stress-induced CMV replication warrants further research as a psychobiological mechanism linking stress, aging and health.
    Full-text · Article · Jan 2014 · Brain Behavior and Immunity
  • Source
    • "In the current study, it is also plausible that increased viral levels are resultant from rather than causal to concurrent disease. In other mammals, stress is well documented as a cause of herpesvirus reactivation, and different stress factors have been shown to have different effects on herpesviral reactivation [35-39]. The finding of a greater prevalence of OtHV3 in sea lions stranding for reasons other than domoic acid toxicosis may reflect increased stress. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Herpesviruses have been recognized in marine mammals, but their clinical relevance is not always easy to assess. A novel otarine herpesvirus-3 (OtHV3) was detected in a geriatric California sea lion (Zalophus californianus), and using a newly developed quantitative PCR assay paired with histology, OtHV3 was associated with esophageal ulcers and B cell lymphoblastic lymphoma in this animal. The prevalence and quantities of OtHV3 were then determined among buffy coats from 87 stranded and managed collection sea lions. Stranded sea lions had a higher prevalence of OtHV3 compared to managed collection sea lions (34.9% versus 12.5%; p = 0.04), and among the stranded sea lions, yearlings were most likely to be positive. Future epidemiological studies comparing the presence and viral loads of OtHV3 among a larger population of California sea lions with and without lymphoid neoplasia or esophageal ulcers would help elucidate the relevance of OtHV3-associated pathologies to these groups.
    Full-text · Article · Dec 2012 · Veterinary Research
Show more