Gastric herpes simplex virus type 1 infection is associated with functional gastrointestinal disorders [with or without FM], 2022, Duffy et al

Full title: Gastric herpes simplex virus type 1 infection is associated with functional gastrointestinal disorders in the presence and absence of comorbid fibromyalgia: a pilot case–control study

Abstract

Purpose
Animal studies have linked gastric herpesvirus infections to symptoms associated with functional gastrointestinal disorders (FGIDs). Herpesviruses have also been hypothesized to contribute to fibromyalgia (FM), a chronic pain syndrome frequently comorbid with FGIDs. The purpose of this study was to compare the prevalence of gastric herpesvirus infection in patients with FGIDs, with and without comorbid FM, to that of controls.

Methods
For this pilot case–control study, we enrolled 30 patients who met both the Rome IV diagnostic criteria for one or more FGIDs and the American College of Rheumatology 2010 criteria for FM, 15 patients with one or more FGIDs without comorbid FM, and 15 control patients. Following endoscopic examination, gastric biopsies were analyzed for herpesvirus DNA and protein, Helicobacter pylori infection, and histological evidence of gastritis. Importantly, the viral nonstructural protein ICP8 was used as a marker to differentiate cell-associated actively replicating virus from latent infection and/or free virus passing through the GI tract.

Results
Gastric herpes simplex virus type 1 (HSV-1) infection, as indicated by ICP8 presence, was significantly associated with FGIDs in the presence (OR 70.00, 95% CI 7.42–660.50; P < .001) and absence (OR 38.50, 95% CI 3.75–395.40; P < .001) of comorbid FM. Neither histological gastritis nor H. pylori infection were found to be associated with FGIDs or FM.

Conclusions
HSV-1 infection was identified in gastric mucosal biopsies from patients with diverse FGIDs, with and without comorbid FM. Larger, multi-center studies investigating the prevalence of this association are warranted.

Open access, https://link.springer.com/article/10.1007/s15010-022-01823-w

 

Looks like a strong result in a small study, though worth noting these folks have a company that's hoping to sell antivirals for FM, ME/CFS, IBS and LC, on the theory that these are all caused by reactivated herpesvirus.

 

If someone has an infection that is causing symptoms in the gut, how can their problems be classified as functional?

 

Exactly. If their results are accurate (Who would have thought science would have come to that?) they have shown that functional gastric disorders are a misdiagnosis of a chronic gut infection not that an infection is associated with it

 

"Historically defined as GI conditions with no organic basis,
FGIDs are now believed to arise from neurogastroenterolog-
ical disturbances and alterations in gut-brain communication"

This sentence in their introduction implies they have already moved on from believing "functional" has no organic basis.

 

Can someone who knows statistics explain how you get an odds ration of 70 with n=15 per group?

If none of the controls had ICP8 then the ratio should be infinity? If one did it should be no more than 15?

 

from the body of the paper: "ICP8 was detected in the biopsies of 83.3% (25/30) of Group 1 patients, 73.3% (11/15) of Group 2 patients, and 6.7% (1/15) of control patients"

odds group 1 = 25/5 = 5
odds control = 1/14 = 0.07

OR = odds group 1 / odds control = (25/5) / (1/14) = 70