Spironolactone Helps Against Herpes Infections

There are limited numbers of antiviral drugs for herpes, but certainly now research showed that spironolactone helps against herpes infections. Spironolactone is an older heart medicine that helps with cardiac failure, but it is also used in unwanted hair growth in women with a hormone disbalance, called hirsutism.

Dr. Swaminathan and colleagues have shown in new research from the University of Utah School of Medicine, Salt Lake City, UT that spironolactone blocks the multiplication of herpes viruses.

Common herpesvirus infections

Although there are 100’s of different herpes virus strains, you will recognize some of the following names.

Herpes, type 1 (HSV-1)

HSV-1 causes cold sores on the lips or inside the mouth.

Herpes, type 2 (HSV-2)

HSV-2 is the cause of genital herpes.

Herpes, type 3 (HSV-3)

HSV-3 causes both chickenpox and shingles (herpes zoster). When the immune system is immature, it presents as chickenpox (mostly in children). But when there is partial immunity from a chickenpox childhood infection, shingles can present in an aging person as a localized shingle infection (medically called “herpes zoster”). An interesting vaccination study showed that vaccination against varicella caused a suppression of chronic HSV-1 so that there were no more cold sores compared to the non-vaccinated group that did.

Herpes, type 4 (HSV-4)

You may know HSV-4 as the Epstein-Barr virus. It is the cause of infectious mononucleosis. Other names for this disease are glandular fever or “kissing disease”.

Treatments for herpes infections

The typical antiviral treatments for HSV-1 and HSV-2 are acyclovir (Zovirax), famciclovir (Famvir), and valacyclovir (Valtrex). As a matter of fact, all these drugs belong to the same pharmacological class of drugs. The same drugs work for chickenpox and shingles/herpes zoster (HSV-3).

In a 2013 publication researchers gave acyclovir (Zovirax) to patients who had been hospitalized with infectious mononucleosis.

They had a shorter duration of hospitalization and fever than a control group not treated with acyclovir. The authors did propose that patients with mononucleosis should receive acyclovir.

Drug-resistant herpes strains

One problem that has surfaced is that herpes drug resistant herpes strains seem to evolve, which are resistant to all of the newer anti-herpes drugs as well. The reason for this is that current anti-herpes drugs work by inhibiting the ability of the virus to replicate DNA, thus stopping its proliferation. When the virus learns to overcome that barrier we call this resistance and this will also affect all of the drugs that utilize the same mechanism of action.

The team from the University of Utah screened several drugs and came upon spironolactone, which is a standard medicine for treating heart failure. Dr. Swaminathan and his team found that spironolactone was also able to stop the viral proliferation, however the drug blocked the virus through a different mechanism. Spironolactone inhibited the action of a protein, the SM protein.

This different mechanism of treating herpes virus infections has opened a new door to further research for newer drugs. Hopefully these new drugs will only have the anti-herpes virus effect, but not the anti-heart failure effect. Dr. Swaminathan is confident that his team will be able to separate these two actions and then come up with a new group of anti-virus drugs.

Spironolactone helps against herpes infections, has few side-effects

Spironolactone has been on the market for over 50 years and has a very good low side effect profile. It is useful for people with heart failure to reduce the retained fluid that can accumulate around the heart or in the lungs. This allows the patient to breathe easier and have more energy. Spironolactone also helps with fluid accumulation in patients who have cirrhosis or have nephrotic syndrome, a kidney disease.

In a completely different set of patients spironolactone can help women who produce too much male hormone in their ovaries. This normalizes the hormones and help them lose the awkward, unwanted facial hair growth.

Some generalized side effects are: mild nausea, vomiting or diarrhea. Breast swelling or tenderness can develop. Dizziness, headache and mild drowsiness can occur. Some people develop leg cramps. Males can experience impotence and difficulties having an erection.

Spironolactone Helps Against Herpes Infections

Spironolactone Helps Against Herpes Infections


It is not often that an existing drug that has been well researched in the past finds a new application in a completely different area than originally developed for. This is the case for spironolactone, which is effective as an anti-herpetic drug. Further research will likely be able to separate the anti-viral effect of spironolactone from the anti-heart failure effect. Dr. Swaminathan and his team did not think that this was too difficult a problem. In the meantime physicians can use spironolactone for severe herpetic infections when the other drugs do not help. These may be cases of drug resistance.

Overall the detection of an anti-herpetic effect of spironolactone has been an important step forward. This is also true with respect to treating the whole group of herpetic diseases.

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Herpes Medication Successful In Mononucleosis

Infectious mononucleosis is a common infectious disease that affects teenagers and young adults. The nickname “Kissing Disease” sounds rather funny, but getting sick with mononucleosis- and the affected persons may not have been kissed at all! – is no fun. The virus can leave the patient unwell and lethargic for several weeks. Missing study hours or being unable to work can be a bad set back.

There is no vaccination against the Epstein-Barr virus, which is the culprit in mononucleosis, and as it is the case with viral illnesses, antibiotics are of no use. The approach so far has been the treatment of symptoms: take over-the counter medicine to bring down a high temperature, drink fluids, use an over-the counter remedy to help against a sore throat and rest. In time mononucleosis would resolve.

Dr. Henry Balfour, who is a herpes specialist at the University of Minnesota, investigated the antiviral drug acylovir (Valtrex) as an intervention for documented Epstein-Barr infections. Students who presented with symptoms of Mononucleosis within 7 days of onset were receiving 3g of valacylovir per day for 2 weeks. Samples of saliva showed a two-fold decrease of the virus load in 8 out of 10 patients. Only one student who had been untreated showed the same result. This effect points to the possibility of reducing or eliminating oral virus transmission by administering Valtrex. The other effect was a decrease in the severity of the illness. The group on medication got better faster. Dr. Balfour pointed out that the current study does have some limitations, due to the small number of participants.

Herpes Medication Successful In Mononucleosis

Herpes Medication Successful In Mononucleosis

He hopes to study the effect of another antiviral agent, valganciclovir (Valcyte) that has a longer intracellular half-life and for this reason should be even more effective.

More information on infectious mononucleosis:

Reference: The Medical Post, page 1, 61, January 10, 2006

Last edited October 30, 2014


Epstein-Barr Virus Responsible For Multiple Sclerosis

Multiple Sclerosis (MS) is a chronic disease, which is dreaded by patients and a puzzle to researchers. While there are MS treatments that control the disease, it remains crucial to treat the early onset. So far the triggering factors have been an unsolved puzzle. Genetic traits and poor nutrition have been implied, yet there has been no conclusive evidence. For a long time there has been the suspicion amongst researchers, that a “multiple sclerosis virus” could be the culprit.

New research, which has been published in the Journal of the American Medical Association shows that the truth is not far off.

Between 1988 and 2000 blood samples have been taken in a study among medical personnel of the United States. Special attention was paid to the group that was granted a permanent disability due to chronic illness. Amongst those who had Multiple Sclerosis, positive blood tests for Epstein Barr virus titers were prominent. The affected individuals were young adults, and the infection with the Epstein-Barr virus had occurred several years before the onset of the illness (the average time between the collection of the blood specimen and the onset of MS was 4 years.) There was also a correlation between the age of the patient and the occurrence of illness. The risk at age 25 was three-fold higher than at age 20 to contract Epstein Barr viral infection. Another strong indicator was an elevated serum level of IgG antibodies to EBNA complex or EBNA-1. This finding was associated with a three-fold risk for the development of MS.

Epstein-Barr Virus Responsible For Multiple Sclerosis

Epstein-Barr Virus Responsible For Multiple Sclerosis

This result would be of interest to young adults who were infected with mononucleosis, as the Epstein-Barr virus, which triggers the seemingly harmless and self-limiting “kissing disease”, seems to entail a higher risk for the development of MS in a younger adult population.

More information on MS:

Reference: JAMA Vol293, Nr.20, 2496-2501, May 25,2005

Last edited October 28, 2014