24 - Genital Herpes

Abstract

As with many other sexually transmitted diseases (STDs), genital herpes infections affect women disproportionately in several ways. First, the infection is more prevalent among women, regardless of the level of sexual activity. Second, the disease tends to be more clinically severe among women, who are more likely to develop systemic illness and neurologic complications during the initial infection. Finally, due to the threat of potential complications during pregnancy and infection of the neonate, women are more affected by the consequences of genital herpes. For pregnant women with genital herpes infections, the fear of transmitting the infection to their newborn is a major concern. Infection of the newborn with HSV (herpes simplex virus) is a rare but devastating disease. The incidence of neonatal herpes varies geographically, with the Pacific Northwest and Scandinavian countries appearing to have the highest rates in the world. Universal immunization with an effective vaccine against HSV-2 infection, delivered in infancy, is likely to be the most effective strategy for control of genital herpes. Such strategy has proven effective against the chronic hepatitis B virus infection. Unfortunately, an effective vaccine appears unlikely in the next few years. A vaccine for genital herpes has been of interest for many decades, and several candidate vaccines have been tested. Promising results have been obtained with the recombinant glycoproteins D and B preparation.