4 ms·

Clickbait. The actual finding appears to be this: if you are diagnosed with HSV (herpes simplex virus), your risk of dementia is 2.5 times higher. If however, y

Clickbait. The actual finding appears to be this: if you are diagnosed with HSV (herpes simplex virus), your risk of dementia is 2.5 times higher. If however, you get an aggressive antiviral treatment, then the risk is reduced by a factor of 10. I take this to mean that overall, the risk do develop dementia is 2.5/10 = 0.25 times the base risk, so overall, the Alzheimer's risk is only 4 times lower with herpes medication, when compared with the general population. The relevant quotes from the article: "The two groups were followed for almost a decade, between 2001 and 2010. In the herpes group, the risk of dementia was over 2.5 times higher than in the control group. Significantly, the study also revealed that aggressive antiviral treatment reduced the relative risk of dementia by 10 times."

carlmr 8y ago
>I take this to mean that overall, the risk do develop dementia is 2.5/10 = 0.25 times the base risk, so overall, the Alzheimer's risk is only 4 times lower with herpes medication, when compared with the general population. Looking at Wikipedia "According to the World Health Organization 67% of the world population under the age of 50 have HSV-1." and according to the source there 11% have HSV-2. There's probably some good amount of overlap between the two, but we have somewhere between 67 and 78% of the population with some form of herpes. In any case the "general population" is closer to having herpes than not having herpes, so we'd probably arrive at a factor somewhere closer to the 10x.
- credit_guy 8y ago
  In most cases that HSV-1 or HSV-2 is dormant, and the person is considered healthy. In this study, the people diagnosed with HSV were considered sick, and in some cases there was a need for the so-called "aggressive antiviral therapy". Now, the study seems quite well conducted, there was a large enough group of people diagnosed with HSV (about 8k people) and a control group of about 25k people who were aged-matched with the first group, but healthy. The two group were followed for 9 years. The main conclusion of the group, that the people with HSV were 2.5 times more likely to develop dementia appears sound, and the power of the experiment probably many times higher than the one necessary to determine statistical significance. The secondary conclusion, that the people "aggressively treated with antivirals" is not as strong, in my opinion. First of all, it's not clear how many in the primary group were subject to that treatment. In an extreme scenario, maybe we are talking only about 50-100, in which case, we may end up with an intended or unintended case of p-hacking. Second, the researchers may have looked for hundreds of things, like how more prone to Alzheimer people who drank more alcohol were, or people who watched too much TV, or other hypotheses. And we may end up again with p-hacking (like in the acne-causing-green-jelly-beans xkcd [1]). [1] https://www.xkcd.com/882/ https://www.xkcd.com/882/
billbrown 8y ago
Yes, it's definitely a clickbait article. Nearly all the links within the article go to other pages on the site and the antiviral drug is never specifically named. I'm guessing it's acyclovir since there's a link to another page on the site in the "Related Coverage" section.
golem14 8y ago
... all things being equal (ie, no/little side effects), a 4x risk improvement seems still pretty good...
ljw1001 8y ago
It's clickbait because it only reduces the risk 10x for people with HSV? You really need to evaluate whether your dismissal of this article is helpful in any way. According to the CDC "54% of persons aged 14 to 49 had HSV-1 infection" 10X for 54% is a big thing.
- credit_guy 8y ago
  I was a bit harsh, I admit. That being said, the claim of 10x reduction is definitely a misrepresentation of the research findings. The 10x reduction was not for people who have had HSV-1 infection at some point in their life, it was for people who were diagnosed with an HSV infection at the beginning of the study. Most people who get cold sores don't seek medical attention for that, they just either ride it out, or apply some Abreva that they buy at their local pharmacy. The population that was subject to the study in no way represents 54% of the total population. And then, the population for which the 10x reduction of dementia risk was only a small subpopulation, namely those where an "aggressive antiviral treatment was applied". The actual article quoted ([1]) even stressed that: "It should be stressed that [...] those treated were the few rare cases severely affected by HSV." [1] https://content.iospress.com/articles/journal-of-alzheimers-disease/jad180266 https://content.iospress.com/articles/journal-of-alzheimers-...

carlmr 8y ago

>I take this to mean that overall, the risk do develop dementia is 2.5/10 = 0.25 times the base risk, so overall, the Alzheimer's risk is only 4 times lower with herpes medication, when compared with the general population. Looking at Wikipedia "According to the World Health Organization 67% of the world population under the age of 50 have HSV-1." and according to the source there 11% have HSV-2. There's probably some good amount of overlap between the two, but we have somewhere between 67 and 78% of the population with some form of herpes. In any case the "general population" is closer to having herpes than not having herpes, so we'd probably arrive at a factor somewhere closer to the 10x.

credit_guy 8y ago
In most cases that HSV-1 or HSV-2 is dormant, and the person is considered healthy. In this study, the people diagnosed with HSV were considered sick, and in some cases there was a need for the so-called "aggressive antiviral therapy". Now, the study seems quite well conducted, there was a large enough group of people diagnosed with HSV (about 8k people) and a control group of about 25k people who were aged-matched with the first group, but healthy. The two group were followed for 9 years. The main conclusion of the group, that the people with HSV were 2.5 times more likely to develop dementia appears sound, and the power of the experiment probably many times higher than the one necessary to determine statistical significance. The secondary conclusion, that the people "aggressively treated with antivirals" is not as strong, in my opinion. First of all, it's not clear how many in the primary group were subject to that treatment. In an extreme scenario, maybe we are talking only about 50-100, in which case, we may end up with an intended or unintended case of p-hacking. Second, the researchers may have looked for hundreds of things, like how more prone to Alzheimer people who drank more alcohol were, or people who watched too much TV, or other hypotheses. And we may end up again with p-hacking (like in the acne-causing-green-jelly-beans xkcd [1]). [1] https://www.xkcd.com/882/ https://www.xkcd.com/882/

billbrown 8y ago

Yes, it's definitely a clickbait article. Nearly all the links within the article go to other pages on the site and the antiviral drug is never specifically named. I'm guessing it's acyclovir since there's a link to another page on the site in the "Related Coverage" section.

golem14 8y ago

... all things being equal (ie, no/little side effects), a 4x risk improvement seems still pretty good...

ljw1001 8y ago

It's clickbait because it only reduces the risk 10x for people with HSV? You really need to evaluate whether your dismissal of this article is helpful in any way. According to the CDC "54% of persons aged 14 to 49 had HSV-1 infection" 10X for 54% is a big thing.

credit_guy 8y ago
I was a bit harsh, I admit. That being said, the claim of 10x reduction is definitely a misrepresentation of the research findings. The 10x reduction was not for people who have had HSV-1 infection at some point in their life, it was for people who were diagnosed with an HSV infection at the beginning of the study. Most people who get cold sores don't seek medical attention for that, they just either ride it out, or apply some Abreva that they buy at their local pharmacy. The population that was subject to the study in no way represents 54% of the total population. And then, the population for which the 10x reduction of dementia risk was only a small subpopulation, namely those where an "aggressive antiviral treatment was applied". The actual article quoted ([1]) even stressed that: "It should be stressed that [...] those treated were the few rare cases severely affected by HSV." [1] https://content.iospress.com/articles/journal-of-alzheimers-disease/jad180266 https://content.iospress.com/articles/journal-of-alzheimers-...