Asymptomatic Shedding of Herpes Simplex Virus 1 and 2: Implications for Prevention of Transmission

Department of Internal Medicine, University of New Mexico, Albuquerque.
The Journal of Infectious Diseases (Impact Factor: 6). 10/2008; 198(8):1098-100. DOI: 10.1086/591914
Source: PubMed
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    • "Whilst, in most HHV infections, viraemia will precede disease and viral shedding can be detected, this is not always true. Asymptomatic shedding is common in individuals with HSV-1 or -2 making it essential to detect the virus in anogenital and oral swabs (Mertz, 2008). It is also unwise to diagnose oral lesions solely upon clinical appearance and tissue morphology revealed by H&E staining . "
    [Show abstract] [Hide abstract] ABSTRACT: Human herpesviruses (HHVs) and human papillomavirus (HPV) are common in the general population and, in immunocompetent people, are mostly carried asymptomatically. However, once an individual becomes immunocompromised by age, illness or HIV infection these dormant viruses can manifest and produce disease. In HIV-positive patients, there is an increased risk of disease caused by HHVs and HPV infections and cancers caused by the oncoviruses Epstein-Barr Virus, HHV-8 and HPV. This workshop examined four questions regarding the viruses associated with oral cancers and disease in the HIV-positive and -negative populations, the immune response, and biomarkers useful for accurate diagnostics of these infections and their sequalae. Each presenter identified a number of key areas where further research is required.
    Full-text · Article · Apr 2016 · Oral Diseases
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    • "A prophylactic vaccine for genital herpes should decrease or prevent genital herpes disease, modify subsequent recurrent disease and recurrent genital HSV shedding as this is the most common source for transmission3940. Because it appears that recurrences are related to the amount of latent virus [41] evaluating protection of neural tissue may be a key outcome variable to assess in evaluating HSV vaccines in animal models. "
    [Show abstract] [Hide abstract] ABSTRACT: Genital herpes simplex virus (HSV) infections are common but results from vaccine trials with HSV-2 glycoprotein D (gD) have been disappointing. We therefore compared a similar HSV gD2 vaccine, to a further truncated gD2 vaccine, to a vaccine with gD2 plus gB2 and gH2/gL2 and to a vaccine with only gB2 and gH2/gL2 in a guinea pig model of genital herpes. All vaccines were administered with cationic liposome-DNA complexes (CLDC) as an adjuvant. All vaccines significantly decreased the severity of acute genital disease and vaginal virus replication compared to the placebo group. The majority of animals in all groups developed at least one episode of recurrent disease but the frequency of recurrent disease was significantly reduced by each vaccine compared to placebo. No vaccine was significantly more protective than gD2 alone for any of the parameters described above. No vaccine decreased recurrent virus shedding. When protection against acute infection of dorsal root ganglia and the spinal cord was evaluated all vaccines decreased the per cent of animal with detectable virus and the quantity of virus but again no vaccine was significantly more protective than another. Improvements in HSV-2 vaccines may require inclusion of more T cell targets, more potent adjuvants or live virus vaccines.
    Full-text · Article · Mar 2011 · Vaccine
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    • "More realistically, a prophylactic HSV-2 vaccine should reduce or prevent genital herpes disease and subsequent clinical recurrences and subsequent virus shedding by either decreasing the pool of latent virus that can reactivate or by induction of immune responses that can control reactivation and shedding. HSV-2 is most frequently transmitted at times when the infected partner is asymptomatically shedding virus [21], [22], [23]. Therefore, a vaccine that decreases the time that an infected person sheds virus that can be transmitted to others should provide a major public health benefit. "
    [Show abstract] [Hide abstract] ABSTRACT: Herpes simplex virus (HSV) infections are common but there is no vaccine available. We evaluated cationic liposome-DNA complexes (CLDC) as an adjuvant for an HSV gD2 vaccine and compared it to an MPL/Alum adjuvant in a guinea pig model of genital herpes. The addition of CLDC to the gD2 vaccine significantly decreased acute and recurrent disease and most importantly the number of days with recurrent virus shedding compared to gD2 alone. Reductions in these outcomes were also detected when gD2+CLDC was compared to gD2+MPL/Alum. When the vaccine and adjuvants were evaluated as therapeutic vaccines, they were ineffective. CLDC enhanced protection compared to MPL/Alum and is the first vaccine to reduce recurrent virus shedding, a key to decreasing the spread of HSV-2.
    Full-text · Article · Oct 2009 · Vaccine
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