A Narrative Review of Alternative Symptomatic Treatments for Herpes Simplex Virus

Abstract

Herpes simplex virus-1 (HSV-1) and -2 (HSV-2) are large, spherically shaped, double-stranded DNA viruses that coevolved with Homo sapiens for over 300,000 years, having developed numerous immunoevasive mechanisms to survive the lifetime of their human host. Although in the continued absence of an acceptable prophylactic and therapeutic vaccine, approved pharmacologics (e.g., nucleoside analogs) hold benefit against viral outbreaks, while resistance and toxicity limit their universal application. Against these shortcomings, there is a long history of proven and unproven home remedies. With the breadth of purported alternative therapies, patients are exposed to risk of harm without proper information. Here, we examined the shortcomings of the current gold standard HSV therapy, acyclovir, and described several natural products that demonstrated promise in controlling HSV infection, including lemon balm, lysine, propolis, vitamin E, and zinc, while arginine, cannabis, and many other recreational drugs are detrimental. Based on this literature, we offered recommendations regarding the use of such natural products and their further investigation.

Keywords: Melissa officinalis; herpes simplex virus; lysine; nucleoside analogs; propolis.

Figure 1

The 11 steps in the life cycle of herpes simplex viruses. Virion attachment (ingress) occurs via specific glycoproteins (1), which also elicit membrane fusion (2). The capsid is then transported to the nucleus (3) and viral DNA released (4) and expressed (5). Viral transcripts are then translated to protein at ribosomes (6), allowing reformation of capsids (7). Meanwhile, viral DNA replication (8) occurs, which is then packaged into capsids (9). Upon budding from the Golgi, the envelope is reformed to encase capsids (10), followed by egress of progeny virions (11). While not firmly established, the beneficial natural products discussed herein likely interfere with protein synthesis (lysine, arginine, steps 6,7) DNA replication (propolis, step 8), and egress (terpenes, step 11).