Herpes simplex primary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Overview

The National Institutes of Health (NIH) in the United States is currently in the midst of phase III trials for a vaccine against HSV-2, called Herpevac. The vaccine has only been shown to be effective for women who have never been exposed to HSV-1. Overall, the vaccine is approximately 48% effective in preventing HSV-2 seropositivity and about 78% effective in preventing symptomatic HSV-2. During initial trials, the vaccine did not exhibit any evidence of the prevention of HSV-2 in males. Additionally, the vaccine only reduced the acquisition of HSV-2 and symptoms due to newly acquired HSV-2 among women who did not have HSV-2 infection at the time they got the vaccine. Because about 20% of people in the United States have HSV-2 infection, this further reduces the population for whom this vaccine might be appropriate.

Primary Prevention

• The most effective way to avoid the transmission of sexually transmitted diseases, including genital herpes, is to abstain from sexual contact, or to be in a long-term and mutually monogamous relationship with a partner who has been tested and is known to be uninfected.

• Genital ulcer diseases can occur in both male and female genital areas that are covered or protected by a latex condom, as well as in areas that are not covered. Correct and consistent use of latex condoms can reduce the risk of genital herpes.

• People with herpes should abstain from sexual activity with uninfected partners when lesions or other symptoms of herpes are present. It is important to know that even if a person does not have any symptoms he or she can still infect sex partners.

• Sex partners of infected persons should be advised that they may become infected and they should use condoms to reduce the risk of infection.

• Sex partners can seek testing to determine if they are infected with HSV. A positive HSV-2 blood test most likely indicates a genital herpes infection.