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U.S. IMMUNIZATION NEWS
"Herpes Simplex Viruses: Is a Vaccine Tenable?"
Journal of Clinical Investigation ( www.jci.org ) (07/01/02) Vol.
110, No. 2, P. 145; Whitley, Richard J.; Roizman, Bernard
Herpes simplex virus (HSV) has been documented since the era of
the ancient Greeks, yet there has not been developed a vaccine
for either HSV-1, which is commonly associated with oral lesions,
or HSV-2, which causes most genital lesions--a task made more
difficult by the disease's ability to lie dormant for a time and
reappear at a later date. The disease is especially dangerous
because it can invade and replicate within the central nervous
system, but little is known about how herpes becomes latent,
reactivates, and moves into the nervous system. In the United
States, some 100 million people are infected with HSV-1, while
between 40 million and 60 million people have HSV-2. In causing
genital ulcerative disease, HSV increases the risk of contracting
HIV by a factor of three or more as well. However, prior
infection with HSV-1 results in milder and less frequent episodes
of HSV-2, and animal models of HSV have effected the prevention
of HSV challenge through vaccination, two factors that suggest a
vaccine against HSV is possible. Two vaccines in development
offer optimism in the fight against HSV: one employs
glycoproteins as subunit vaccines to attach to the virus in
combination with adjuvant, while the other is a genetically
engineered live, attenuated vaccine that has been altered to
remove its neurovirulence sequences. Though the vaccines have
shown some efficacy in humans, clinical evaluations of HSV
vaccines have been lacking in methodology, providing inconclusive
evidence about the vaccines.
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