Alzheimer’s
disease (AD) is characterized by the presence
of β-amyloid plaques (Aβ) and neurofibrillary tangles
(NFTs) in the brain. The prevalence of the disease is increasing and
is expected to reach 141 million cases by 2050. Despite the risk factors
associated with the disease, there is no known causative agent for
AD. Clinical trials with many drugs have failed over the years, and
no therapeutic has been approved for AD. There is increasing evidence
that pathogens are found in the brains of AD patients and controls,
such as human herpes simplex virus-1 (HSV-1). Given the lack of a
human model, the route for pathogen entry into the brain remains open
for scrutiny and may include entry via a disturbed blood–brain
barrier or the olfactory nasal route. Many factors can contribute
to the pathogenicity of HSV-1, such as the ability of HSV-1 to remain
latent, tau protein phosphorylation, increased accumulation of Aβ
in
vivo
and
in vitro
,
and repeated cycle of reactivation if immunocompromised. Intriguingly,
valacyclovir, a widely used drug for the treatment of HSV-1 and HSV-2
infection, has shown patient improvement in cognition compared to
controls in AD clinical studies. We discuss the potential role of
HSV-1 in AD pathogenesis and argue for further studies to investigate
this relationship.