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4 TREATING DEADLY VIRUSAFor most individuals living with herpes simplex virus(HSV), sporadic outbreaks of cold sores or fever blisters arethe only symptoms. Many experience no symptoms atall. However, in rare cases, the HSV infectioncan travel up through the sinuses andinto the brain, instead of towards theskin, causing an infection calledherpes simplex encephalitis(HSE). Most people canhandle this form of braininfection with minorconsequence, but some aregenetically predisposedto an excessively strongimmune response to theinfection.Currently, there is noway to help save patientswho arrive at the hospital withHSE. Even with aggressive antiviraltherapy, the immune systemcauses excessive inflammation thatdestroys brain tissue and typically resultsin severe debilitation and even death.“Imagine a neighborhood drugstore being robbed,” saysPatric Lundberg, PhD, assistant professor of microbiologyand molecular cell biology at EVMS. “Do you call the localpolice officer or do you call for the U.S. Army to drop abomb on the whole neighborhood?”Dr. Lundberg is trying to determine why the responseto HSE can be so dramatically different in each individual— why the body sometimes calls for an all-out assault, orbomb, while other times it is a more localized response,the police officer.While encephalitis is very rare, the herpes virus is oneof the most common sexually transmitted diseases in theU.S., affecting one in five Americans. Dr. Lundberg saysas many as 70 to 80 percent of people carry the latentvirus in their nerves, but only about a third with the virusexperience symptoms. No more than 1,000 patients eachyear develop the life-threatening form of HSE.By understanding a patient’s genetic makeup, physicianscan begin to provide personalized medicine to individualswith HSE, saving lives and reducing sickness, Dr.Lundberg says.Understanding the immune system’s response to thevirus not only helps save the lives of those with HSE, butit may yield some insight into other viruses that infect thebrain and diseases that cause brain inflammation, such asAlzheimer’s and Parkinson’s diseases.WHILE ENCEPHALITIS ISVERY RARE, THE HERPESVIRUS IS ONE OF THE MOSTCOMMON SEXUALLYTRANSMITTED DISEASES INTHE U.S., AFFECTING ONE INFIVE AMERICANS.32 FALL 2010 WWW.EVMS.EDUMEDICAL BREAKTHROUGHS