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Hemmingsson, Eva-Stina
Publications (4 of 4) Show all publications
Weidung, B., Hemmingsson, E.-S., Olsson, J., Sundström, T., Blennow, K., Zetterberg, H., . . . Lövheim, H. (2022). VALZ-Pilot: High-dose valacyclovir treatment in patients with early-stage Alzheimer's disease. Alzheimer’s & Dementia: Translational Research & Clinical Interventions, 8(1), Article ID e12264.
Open this publication in new window or tab >>VALZ-Pilot: High-dose valacyclovir treatment in patients with early-stage Alzheimer's disease
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2022 (English)In: Alzheimer’s & Dementia: Translational Research & Clinical Interventions, E-ISSN 2352-8737, Vol. 8, no 1, article id e12264Article in journal (Refereed) Published
Abstract [en]

Introduction: Herpes simplex virus (HSV) may be involved in Alzheimer's disease (AD) pathophysiology. The antiviral valacyclovir inhibits HSV replication.

Methods: This phase-II pilot trial involved valacyclovir administration (thrice daily, 500 mg week 1, 1000 mg weeks 2–4) to persons aged ≥ 65 years with early-stage AD, anti-HSV immunoglobulin G, and apolipoprotein E ε4. Intervention safety, tolerability, feasibility, and effects on Mini-Mental State Examination (MMSE) scores and cerebrospinal fluid (CSF) biomarkers were evaluated.

Results: Thirty-two of 33 subjects completed the trial on full dosage. Eighteen percent experienced likely intervention-related mild, temporary adverse events. CSF acyclovir concentrations were mean 5.29 ± 2.31 μmol/L. CSF total tau and neurofilament light concentrations were unchanged; MMSE score and CSF soluble triggering receptor expressed on myeloid cells 2 concentrations increased (P = .02 and .03).

Discussion: Four weeks of high-dose valacyclovir treatment was safe, tolerable, and feasible in early-stage AD. Our findings may guide future trial design.

Place, publisher, year, edition, pages
John Wiley & Sons, 2022
Keywords
Alzheimer's disease, apolipoprotein E ε4, feasibility study, herpes simplex, pilot project, valacyclovir
National Category
Neurology Neurosciences
Identifiers
urn:nbn:se:umu:diva-203082 (URN)10.1002/trc2.12264 (DOI)000908294000001 ()35310522 (PubMedID)2-s2.0-85137403065 (Scopus ID)
Funder
Swedish Research Council, 2018‐02532EU, Horizon 2020, 860197
Available from: 2023-01-16 Created: 2023-01-16 Last updated: 2023-09-05Bibliographically approved
Hemmingsson, E.-S., Hjelmare, E., Weidung, B., Olsson, J., Josefsson, M., Adolfsson, R., . . . Lövheim, H. (2021). Antiviral treatment associated with reduced risk of clinical Alzheimer's disease: A nested case-control study. Alzheimer’s & Dementia: Translational Research & Clinical Interventions, 7(1), Article ID e12187.
Open this publication in new window or tab >>Antiviral treatment associated with reduced risk of clinical Alzheimer's disease: A nested case-control study
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2021 (English)In: Alzheimer’s & Dementia: Translational Research & Clinical Interventions, E-ISSN 2352-8737, Vol. 7, no 1, article id e12187Article in journal (Refereed) Published
Abstract [en]

Introduction: In this nested case-control study, we investigated if antiviral treatment given prior to onset of Alzheimer's disease (AD) could influence incident AD.

Methods: From a large population-based cohort study in northern Sweden, 262 individuals that later developed AD were compared to a non-AD matched control group with respect to prescriptions of herpes antiviral treatment. All included subjects were herpes simplex virus 1 (HSV1) carriers and the matching criteria were age, sex, apolipoprotein E genotype (ε4 allele carriership), and study sample start year.

Results: Among those who developed AD, 6 prescriptions of antivirals were found, compared to 20 among matched controls. Adjusted for length of follow-up, a conditional logistic regression indicated a difference in the risk for AD development between groups (odds ratio for AD with an antiviral prescription 0.287, P = .018).

Discussion: Antiviral treatment might possibly reduce the risk for later development of HSV1-associated AD.

Place, publisher, year, edition, pages
John Wiley & Sons, 2021
Keywords
Alzheimer’s disease, antiviral treatment, apolipoprotein E gene, dementia, herpes simplex, major neurocognitive disorder, nested case-control study
National Category
Geriatrics
Identifiers
urn:nbn:se:umu:diva-187310 (URN)10.1002/trc2.12187 (DOI)000750546300053 ()2-s2.0-85114262531 (Scopus ID)
Funder
Region VästerbottenThe Dementia Association - The National Association for the Rights of the DementedAlzheimerfondenKnut and Alice Wallenberg FoundationForte, Swedish Research Council for Health, Working Life and Welfare, 2013-2056
Available from: 2021-09-07 Created: 2021-09-07 Last updated: 2024-04-08Bibliographically approved
Lopatko Lindman, K., Hemmingsson, E.-S., Weidung, B., Brännström, J., Josefsson, M., Olsson, J., . . . Lövheim, H. (2021). Herpesvirus infections, antiviral treatment, and the risk ofdementia: a registry-based cohort study in Sweden. Alzheimer’s & Dementia: Translational Research & Clinical Interventions, 7(1), Article ID e12119.
Open this publication in new window or tab >>Herpesvirus infections, antiviral treatment, and the risk ofdementia: a registry-based cohort study in Sweden
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2021 (English)In: Alzheimer’s & Dementia: Translational Research & Clinical Interventions, E-ISSN 2352-8737, Vol. 7, no 1, article id e12119Article in journal (Refereed) Published
Abstract [en]

Introduction: Herpesviruses, including Herpes simplex virus type 1 (HSV1) and varicella zoster‐virus (VZV), have been implicated in Alzheimer's disease (AD) development. Likewise, antiviral treatment has been suggested to protect against dementia development in herpes‐infected individuals.

Methods: The study enrolled 265,172 subjects aged ≥ 50 years, with diagnoses of VZV or HSV, or prescribed antiviral drugs between 31 December 2005 and 31 December 2017. Controls were matched in a 1:1 ratio by sex and birth year.

Results: Antiviral treatment was associated with decreased risk of dementia (adjusted hazard ratio [HR] 0.89, 95% confidence interval [CI] 0.86 to 0.92), while herpes infection without antiviral drugs increased the risk of dementia (adjusted HR 1.50, 95% CI 1.29 to 1.74).

Discussion: Antiviral treatment was associated with a reduced long‐term risk of dementia among individuals with overt signs of herpes infection. This is consistent with earlier findings indicating that herpesviruses are involved in the pathogenesis of AD.

Place, publisher, year, edition, pages
John Wiley & Sons, 2021
Keywords
Alzheimer’s disease, antiviral agents, dementia, herpes simplex, herpes zoster, retrospective cohort study, varicella zoster
National Category
Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-182629 (URN)10.1002/trc2.12119 (DOI)000750546300096 ()2-s2.0-85103930201 (Scopus ID)
Available from: 2021-04-27 Created: 2021-04-27 Last updated: 2023-09-05Bibliographically approved
Hemmingsson, E.-S., Gustavsson, M., Isaksson, U., Karlsson, S., Gustavsson, Y., Sandman, P.-O. & Lövheim, H. (2018). Prevalence of pain and pharmacological pain and treatment among old people in nursing homes in 2007 and 2013. European Journal of Clinical Pharmacology, 74(4), 483-488
Open this publication in new window or tab >>Prevalence of pain and pharmacological pain and treatment among old people in nursing homes in 2007 and 2013
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2018 (English)In: European Journal of Clinical Pharmacology, ISSN 0031-6970, E-ISSN 1432-1041, Vol. 74, no 4, p. 483-488Article in journal (Refereed) Published
Abstract [en]

Purpose: Many elderly people living in nursing homes experience pain and take analgesic medication. The aim of this study was to analyze the prevalence of pain and pharmacological pain treatment among people living in nursing homes in Sweden, in two large, comparable, samples from 2007 to 2013.

Methods: Cross-sectional surveys were performed in 2007 and 2013, including all residents in nursing homes in the county of Västerbotten, Sweden. A total of 4933 residents (2814 and 2119 respectively) with a mean age of 84.6 and 85.0 years participated. Of these, 71.1 and 72.4% respectively were cognitively impaired. The survey was completed by the staff members who knew the residents best.

Results: The prescription of opioids became significantly more common while the use of tramadol decreased significantly. The staff reported that 63.4% in 2007 and 62.3% in 2013 had experienced pain. Of those in pain, 20.2% in 2007 and 16.8% in 2013 received no treatment and 73.4 and 75.0% respectively of those with pain, but no pharmacological treatment, were incorrectly described by the staff as being treated for pain.

Conclusions: There has been a change in the pharmacological analgesic treatment between 2007 and 2013 with less prescribing of tramadol and a greater proportion taking opioids. Nevertheless, undertreatment of pain still occurs and in many cases, staff members believed that the residents were prescribed analgesic treatment when this was not the case.

Place, publisher, year, edition, pages
Springer, 2018
Keywords
pain, elderly, nursing home, analgesic drugs, dementia
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-144537 (URN)10.1007/s00228-017-2384-2 (DOI)000427468600011 ()29260276 (PubMedID)2-s2.0-85038368509 (Scopus ID)
Available from: 2018-02-06 Created: 2018-02-06 Last updated: 2023-03-24Bibliographically approved
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