Circumcision Tied to Drop in Herpes, Too

“This is an example that less is more,” said Sharon Hillier, PhD, professor of obstetrics and gynecology at the University of Pittsburgh, who moderated the press briefing. She was not involved in the trial.

“This is an intervention that can be done one time and can provide years of benefits that are sustained,” she told MedPage Today.

“We don’t hear enough about the long-term benefits at the population level from circumcision. This is really important news that confirms what we have learned in the past about [circumcision’s] effect in reducing HIV infection, but also [shows] that it is a multipurpose technology that is ... preventing HSV-2. The fact that it is doing so much for men in preventing HIV and other infections is a story that is not being told enough.”

Circumcision, Religious Freedom, and Herpes Infections in New York City
If you ever find yourself in the coffee line at a medical conference, be prepared to eavesdrop on a gaggle of doctors exchanging the medical equivalent of “war stories,” wild tales of clinical misadventures and treatment plans gone awry. It was precisely at such a venue that I heard what easily qualifies as one of the strangest - and scariest - medical tale of recent times.

It actually began in 2004 when the New York City Department of Health received reports of 3 newborn, male babies who contracted herpes simplex virus (HSV-1). All of them required weeks of hospital care and intravenous injections of powerful antiviral medication. Tragically, one of them died from the infection.

Unlike a mere cold sore or an embarrassing, painful crop of genital blisters, herpes for a newborn is truly a life-and-death matter. Aggressive and relentless, the herpes virus can destroy an infant’s brain in a matter of days. Every pediatrician who notices any type of blister on a newborn’s body shudders as he contemplates whether its cause is merely an abrasive blanket or, far worse, a harbinger of a systemic infection with herpes.

But the story only gets stranger. Using a mixture of detective work and medical acumen, the New York City Department of Health figured out that all of these babies contracted herpes shortly after undergoing a ritual circumcision by the same mohel, the religious figure in the Jewish faith charged with conducting the ancient and spiritually important ceremony called a bris.

Hillier noted that in the U.S. there have been movements to prevent circumcision. “I don’t think we have done enough to get the word out that male circumcision is a powerful, life-long prevention of infection, and one that can have a real impact on this epidemic,” she said.

Auvert suggested that he would like to see circumcision occur among babies, as is often performed in religious rites. However, he added, the logistics of performing circumcision in Africa make early male circumcision difficult at this time.

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Primary source: Conference on Retroviruses and Opportunistic Infections
Source reference: Auvert B, et al “ANRS-12126 - Impact of male circumcision roll-out on HSV-2 prevalence among men: Orange Farm, South Africa” CROI 2012; Paper #37.

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