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  <front>
    <journal-meta>
      <journal-title-group>
        <journal-title>Cosmological and Astrobiological Review</journal-title>
      </journal-title-group>
      <issn pub-type="ppub">0000-0000</issn>
      <issn pub-type="epub">0000-0000</issn>
      <publisher>
        <publisher-name>SAPCRAA</publisher-name>
        <publisher-loc>Banja Luka, Bosnia and Herzegovina</publisher-loc>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="publisher-id">1516</article-id>
      <article-id pub-id-type="doi">https://doi.org/10.65932/CAR-2023-1-5</article-id>
      <title-group>
        <article-title>Reactivation risk of latent human herpesviruses under spaceflight stressors: an integrative review and the sherri multi-axis risk index</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <name>
            <surname>Bokuchava</surname>
            <given-names>Ana</given-names>
          </name>
          <contrib-id contrib-id-type="orcid">https://orcid.org/0009-0008-5911-6290</contrib-id>
        </contrib>
      </contrib-group>
      <pub-date pub-type="epub">
        <day>30</day>
        <month>12</month>
        <year>2023</year>
      </pub-date>
      <volume>1</volume>
      <issue>1</issue>
      <fpage>61</fpage>
      <lpage>71</lpage>
      <self-uri xlink:href="https://www.sapcraa.com/article-preview/1516"/>
      <abstract>
        <p>Reactivation of latent human herpesviruses (HHV) — EBV, VZV, HSV-1, CMV, and the roseoloviruses HHV-6 and HHV-7 — is one of the most consistently documented physiological consequences of long-duration spaceflight. Across NASA&apos;s three-decade sampling programme, herpesvirus shedding has been documented in 53% of astronauts on short-duration shuttle missions and 61% on long-duration ISS missions, with shedding frequency, viral copy number, and duration all increasing with mission length (Mehta et al., 2017; Rooney et al., 2019). The mechanism is well-characterised: spaceflight activates the HPA and SAM axes, elevating cortisol and catecholamines and suppressing cell-mediated immunity (with declines in CD8+ Tcell function and NK-cell cytotoxicity of approximately 50% by flight day 90), thereby compromising the surveillance mechanisms that maintain latency (Crucian et al., 2018; Bigley et al., 2019). The first published case of HSV-1 dermatitis during a long-duration ISS mission (Mehta et al., 2022) demonstrates that reactivation can progress from asymptomatic shedding to clinical manifestation. The dialectical question for missions beyond low-Earth orbit — extended lunar missions and Mars transits of approximately 6–9 months one-way — is whether the risk established for ≤6-month ISS missions will scale linearly, sub-linearly, or super-linearly with mission duration, and whether available antiviral countermeasures (acyclovir, valacyclovir prophylaxis) can be deployed under exploration-class operational constraints. In this article I review the 2016–2022 literature and propose, as the original contribution, the Spaceflight Herpesvirus Reactivation Risk Index (SHERRI) — a normalised composite metric on [0,1] integrating five dimensions (baseline seroprevalence, shedding rate, viral copy number, clinicalmanifestation probability, and countermeasure availability) that returns a quantitative per-virus risk ranking for mission planning. Applied to the six principal latent herpesviruses, SHERRI returns the highest risk for EBV (≈0.62) and VZV (≈0.58), intermediate scores for CMV (≈0.45) and HSV-1 (≈0.50), and lower scores for HHV-6 and HHV-7</p>
      </abstract>
      <kwd-group kwd-group-type="author">
        <kwd>spaceflight</kwd>
        <kwd>latent herpesvirus reactivation</kwd>
        <kwd>EBV</kwd>
        <kwd>VZV</kwd>
        <kwd>HSV-1</kwd>
        <kwd>CMV</kwd>
        <kwd>immune dysregulation</kwd>
        <kwd>NK cell function</kwd>
        <kwd>salivary cortisol</kwd>
        <kwd>antiviral countermeasures</kwd>
        <kwd>exploration medicine</kwd>
      </kwd-group>
    </article-meta>
  </front>
</article>
