Cause Of Genital Ulcer Disease Research Articles

Vaccine value profile for herpes simplex virus

Herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) are chronic, highly prevalent viral infections that cause significant morbidity around the world. HSV-2 is sexually transmitted and is the leading cause of genital ulcer disease (GUD). It also increases the risk of HIV acquisition, fueling the HIV epidemic. HSV-1 is typically acquired in childhood through nonsexual contact and contributes to oral and ocular disease, but it can also be sexually transmitted to cause GUD. Both HSV-1 and HSV-2 cause neonatal herpes and neurologic disease. Given the ubiquitous nature of HSV-1 and HSV-2 infections and the limited existing prevention and control measures, vaccination would be the most efficient strategy to reduce the global burden of morbidity related to HSV infection. Vaccine strategies include prophylactic vaccination, which would prevent infection among susceptible persons and would likely be given to adolescents, and therapeutic vaccinations, which would be given to people with symptomatic genital HSV-2 infection. This document discusses the vaccine value profile of both types of vaccines.This ‘Vaccine Value Profile’ (VVP) for HSV is intended to provide a high-level, holistic assessment of the information and data that are currently available to inform the potential public health, economic and societal value of pipeline vaccines and vaccine-like products. This VVP was developed by subject matter experts from academia, non-profit organizations, government agencies and multi-lateral organizations. All contributors have extensive expertise on various elements of the HSV VVP and collectively aimed to identify current research and knowledge gaps. The VVP was developed using only existing and publicly available information.

Novel Adjuvant S-540956 Targets Lymph Nodes and Reduces Genital Recurrences and Vaginal Shedding of HSV-2 DNA When Administered with HSV-2 Glycoprotein D as a Therapeutic Vaccine in Guinea Pigs.

Herpes simplex virus type 2 (HSV-2) is a leading cause of genital ulcer disease and a major risk factor for acquisition and transmission of HIV. Frequent recurrent genital lesions and concerns about transmitting infection to intimate partners affect the quality of life of infected individuals. Therapeutic vaccines are urgently needed to reduce the frequency of genital lesions and transmission. S-540956 is a novel vaccine adjuvant that contains CpG oligonucleotide ODN2006 annealed to its complementary sequence and conjugated to a lipid that targets the adjuvant to lymph nodes. Our primary goal was to compare S-540956 administered with HSV-2 glycoprotein D (gD2) with no treatment in a guinea pig model of recurrent genital herpes (studies 1 and 2). Our secondary goals were to compare S-540956 with oligonucleotide ODN2006 (study1) or glucopyranosyl lipid A in a stable oil-in-water nano-emulsion (GLA-SE) (study 2). gD2/S-540956 reduced the number of days with recurrent genital lesions by 56%, vaginal shedding of HSV-2 DNA by 49%, and both combined by 54% compared to PBS, and was more efficacious than the two other adjuvants. Our results indicate that S-540956 has great potential as an adjuvant for a therapeutic vaccine for genital herpes, and merits further evaluation with the addition of potent T cell immunogens.

High salt diet impairs the protective immunity against mucosal HSV-2 infection

Abstract Herpes simplex virus type2 (HSV-2) is the main cause of genital ulcer disease. Because of asymptomatic viral shedding, HSV-2 is highly prevalent and infected nearly 500 million people worldwide. Recently, excessive sodium intake has threatened global health. It is well known that excessive sodium intake affects various diseases by altering gut microbiome. However, the effect of excessive sodium intake on vaginal microbiome and vaginal immune system is unknown. In this study, we investigate the effects of high salt diet on vaginal microbiome and HSV-2 disease progression. We found that high salt diet compromises the anti-viral immunity in a mouse HSV-2 model. In 16S ribosomal RNA sequencing of vaginal microbiome, high salt diet results vaginal dysbiosis. High salt diet induced vaginal dysbiosis promotes neutrophil infiltration in vaginal tissue and vaginal lumen. In addition, Single-cell RNA analysis of vaginal neutrophil reveals dominant increase in neutrophil expressing MMPs that could damage vaginal tissue. Our findings suggest that high salt diet related vaginal dysbiosis impairs antiviral protection via neutrophil recruitment.

The changing epidemiology of genital ulcer disease in South Africa: has donovanosis been eliminated?

ObjectivesWe used an in-house molecular assay for the detection of Klebsiella granulomatis in ulcer specimens collected over a 12-year surveillance period in order to determine whether a diagnosis of donovanosis...

Seroprevalence and associated factors of HSV-2 infection among general population in Shandong Province, China

BackgroundHerpes simplex virus type-2 (HSV-2) infection is the main cause of genital ulcer disease and increases the risk of HIV acquisition. Little information is available regards the epidemiological characteristics of HSV-2 among general population in China. The aim of this study was to explore seroprevalence and associated factors of HSV-2 and provide information for design of HSV-2 control strategy in Shandong, China.MethodsIn this cross-sectional study, a total of 8074 persons, 18–49 years of age, were selected using multi-stage probability sampling to represent the general population of Shandong in 2016. Demographic data were collected through face-to-face interviews. Other variables were obtained by self-administered questionnaire surveys. Blood was collected for HSV-2 IgG detection with ELISA.ResultsA total of 7256 sexually-active participants were included in the analysis. The weighted seroprevalence of HSV-2 infection was 4.2% (95% confidence interval [CI], 3.2–5.3) in females, which was significant higher than that in males (2.7%; 95% CI, 1.1–4.2) (P = 0.04). The seroprevalence of HSV-2 was higher in individuals from eastern region (6.4%; 95% CI, 5.9–6.9) and urban areas (4.3%; 95% CI, 2.6–6.0) of Shandong than those from other regions (P < 0.01). Associated factors for HSV-2 infection among men were being urban residents (adjusted odds ratio [AOR], 2.36; 95% CI, 1.14–4.88), having two or more sex partners in the past year (AOR, 3.22; 95% CI, 1.90–5.43) and having commercial sex (AOR, 1.51; 95% CI, 1.00–2.26). Among females, being divorced or widowed (AOR, 1.79; 95% CI, 1.08–2.97), having a tattoo (AOR, 2.89; 95% CI, 1.07–7.84), and being dissatisfied with the sex activity quality (AOR, 2.12; 95% CI, 1.24–3.63) was associated with HSV-2 infection.ConclusionsThis study showed a relatively low burden of HSV-2 in Shandong province, China compared with the seroprevalence reported in many other provinces and countries. HSV-2 control programs in Shandong should focus on eastern, urban and female residents, and pay more attention to individuals with identified associated factors.

Atypical presentation of genital herpes in a retroviral disease patient on highly active anti-retroviral therapy

Herpes Simplex Virus type 2 (HSV-2) is the leading cause of Genital Ulcer Disease (GUD) worldwide. In HIV infected persons, it typically presents with increased number of recurrent genital lesions which often have severe and prolonged presentations. There are reports that patients receiving highly active antiretroviral therapy (HAART) may be more prone to chronic genital ulcers and a higher risk of acyclovir-resistant herpes infection than is seen in immune competent patients. We present a case of recurrent genital herpes infection in a sexually active 15 year old known HIV patient.Keywords: Recurrent genital ulcer, HSV-2, HIV, HAART

Sexual behavioural correlates of herpes simplex virus type 2 infections among pregnant women in South-western Nigeria

Background: Herpes simplex virus type 2 (HSV-2) is the most common cause of genital ulcer disease. It leads to lifelong latent infection and this raises concerns among women of reproductive age, considering the risk of neonatal transmission. This study was undertaken to identify the sexual behavioural correlates of HSV-2 infection as well as negative pregnancy outcomes.Methods: The cross-sectional study was conducted between March and August 2013, in the antenatal clinic of the University College Hospital Ibadan. A total of 270 pregnant women aged 20 to 44 years were enrolled and their serum samples were tested for HSV-2 IgG using type specific third generation ELISA (DIAPRO Milano Italy). Pretested validated questionnaire were used to obtain bio-data, sexual behaviour and obstetrics history of the participants. Data analyses was done using SPSS version 20.Results: The seroprevalence of HSV-2 type specific IgG was 33.3% (90/270). Logistic regression analysis showed that multiple lifetime sexual partners, early age at sexual debut, previous history of sexually transmitted infections (STIs) and having spouses whose work keep them away from home, were independent risk factors for HSV-2 infection. Obstetrics complications such as intrauterine foetal death, congenital malformations and spontaneous abortion were also strongly associated.Conclusions: The predictors of HSV-2 infection in this study may be important in selecting candidates for screening tests and developing strategies towards effective health promotion campaign.

The Etiology of Genital Ulcer Disease and Coinfections With Chlamydia trachomatis and Neisseria gonorrhoeae in Zimbabwe: Results From the Zimbabwe STI Etiology Study

In many countries, sexually transmitted infections (STIs) are treated syndromically. Thus, patients diagnosed as having genital ulcer disease (GUD) in Zimbabwe receive a combination of antimicrobials to treat syphilis, chancroid, lymphogranuloma venereum (LGV), and genital herpes. Periodic studies are necessary to assess the current etiology of GUD and assure the appropriateness of current treatment guidelines. We selected 6 geographically diverse clinics in Zimbabwe serving high numbers of STI cases to enroll men and women with STI syndromes, including GUD. Sexually transmitted infection history and risk behavioral data were collected by questionnaire and uploaded to a Web-based database. Ulcer specimens were obtained for testing using a validated multiplex polymerase chain reaction (M-PCR) assay for Treponema pallidum (TP; primary syphilis), Haemophilus ducreyi (chancroid), LGV-associated strains of Chlamydia trachomatis, and herpes simplex virus (HSV) types 1 and 2. Blood samples were collected for testing with HIV, treponemal, and nontreponemal serologic assays. Among 200 GUD patients, 77 (38.5%) were positive for HSV, 32 (16%) were positive for TP, and 2 (1%) were positive for LGV-associated strains of C trachomatis. No H ducreyi infections were detected. No organism was found in 98 (49.5%) of participants. The overall HIV positivity rate was 52.2% for all GUD patients, with higher rates among women compared with men (59.8% vs 45.2%, P < 0.05) and among patients with HSV (68.6% vs 41.8%, P < 0.0001). Among patients with GUD, 54 (27.3%) had gonorrhea and/or chlamydia infection. However, in this latter group, 66.7% of women and 70.0% of men did not have abnormal vaginal or urethral discharge on examination. Herpes simplex virus is the most common cause of GUD in our survey, followed by T. pallidum. No cases of chancroid were detected. The association of HIV infections with HSV suggests high risk for cotransmission; however, some HSV ulcerations may be due to HSV reactivation among immunocompromised patients. The overall prevalence of gonorrhea and chlamydia was high among patients with GUD and most of them did not meet the criteria for concomitant syndromic management covering these infections.

A trivalent subunit antigen glycoprotein vaccine as immunotherapy for genital herpes in the guinea pig genital infection model

ABSTRACTAn estimated 417 million people worldwide ages 15 to 49 are infected with herpes simplex virus type 2 (HSV-2), the most common cause of genital ulcer disease. Some individuals experience frequent recurrences of genital lesions, while others only have subclinical infection, yet all risk transmitting infection to their intimate partners. A vaccine was developed that prevents shingles, which is a recurrent infection caused by varicella-zoster virus (VZV), a closely related member of the Herpesviridae family. The success of the VZV vaccine has stimulated renewed interest in a therapeutic vaccine for genital herpes. We have been evaluating a trivalent subunit antigen vaccine for prevention of genital herpes. Here, we assess the trivalent vaccine as immunotherapy in guinea pigs that were previously infected intravaginally with HSV-2. The trivalent vaccine contains HSV-2 glycoproteins C, D, and E (gC2, gD2, gE2) subunit antigens administered with CpG and alum as adjuvants. We previously demonstrated that antibodies to gD2 neutralize the virus while antibodies to gC2 and gE2 block their immune evasion activities, including evading complement attack and inhibiting activities mediated by the IgG Fc domain, respectively. Here, we demonstrate that the trivalent vaccine significantly boosts ELISA titers and neutralizing antibody titers. The trivalent vaccine reduces the frequency of recurrent genital lesions and vaginal shedding of HSV-2 DNA by approximately 50% and almost totally eliminates vaginal shedding of replication-competent virus, suggesting that the trivalent vaccine is a worthy candidate for immunotherapy of genital herpes.

Efficient production of recombinant glycoprotein D of herpes simplex virus type 2 in Pichia pastoris and its protective efficacy against viral challenge in mice

Herpes simplex virus type 2 (HSV-2) infection is the leading cause of genital ulcer disease and a significant public health concern. However, there are no approved vaccines available to prevent HSV-2 infection. The glycoprotein D (gD) of HSV-2 is the most important candidate antigen for vaccine development. In this study, a truncated form of gD (codons 1-340, gD1-340) was produced as a secretory protein in the methylotrophic yeast Pichia pastoris. The recombinant gD1-340 with a His6 tag was purified to homogeneity by one-step affinity chromatography. Mice immunized with the recombinant gD1-340 developed high levels of antigen-specific antibody responses with HSV-2 neutralizing activity. Immunization with the recombinant gD1-340 conferred significant protection against lethal HSV-2 infection in mice. Moreover, measurement of the secretion of gD1-340-specific cytokines demonstrated that the recombinant gD1-340 induced mixed Th1/Th2 cellular immune responses. These findings indicated that P. pastoris-derived gD1-340 represents a promising HSV-2 vaccine candidate with strong immunogenicity and prophylactic efficacy.

Seroprevalence and correlates of herpes simplex virus type 2 infection among young adults in Arkhangelsk, Northwest Russia: a population-based cross-sectional study.

BackgroundHerpes simplex virus type 2 (HSV-2) infection is the most common cause of genital ulcer disease (GUD) worldwide. Mother to child transmission causes high morbidity and mortality among infants. Russia is on the brink of a generalized HIV-epidemic, but Arkhangelsk is still a low-prevalence area. HSV-2 infection is associated with a three-fold increased risk of HIV-infection. The evidence on the seroprevalence of HSV-2 in Russia is limited. The aim of this study was to assess HSV-2 seroprevalence and correlates among young adults in the city of Arkhangelsk.Methods1243 adults aged 18-39 years participated in a cross-sectional population-based study, recruited by a public opinion agency applying a quota sampling method to achieve a data set with similar age- and sex-distribution as the population in Arkhangelsk. All participants completed a standardized, self-administrated questionnaire and were tested for HSV-2. Associations between HSV-2 seropositivity and selected sociodemographic and behavioral factors, and self-reported history of sexually transmitted infections (STIs) were studied by multivariable logistic regression.ResultsHSV-2 seroprevalence was 18.8 %: 12.2 % (95 % confidence interval, CI 9.7-15.2) among men and 24.0 % (95 % CI 20.1-27.3) among women. Among men, HSV-2 positivity was associated with being divorced/widowed (OR = 2.85, 95 % CI 1.06-7.70), cohabitation (OR = 2.45, 95 % CI 1.07-5.62), and a history of STIs (OR = 2.11, 95 % CI 1.14-3.91). In women, HSV-2 positivity was associated with high income (OR = 3.11, 95 % CI 1.45-6.71) and having a lifetime number of sexual partners between 2 and 5 (OR = 2.72, 95 % CI 1.14-6.51), whereas sexual debut at age 18 years or older was inversely associated with the outcome (OR = 0.47, 95 % CI 0.31-0.72). In both sexes, increasing age was the strongest correlate of HSV-2 seropositivity in multivariable analyses.ConclusionThe HSV-2 seroprevalence was twice as high in women than in men and increased with age in both sexes, and similar to that reported from high-prevalence countries in Europe and the USA. The high prevalence of HSV-2 among women in childbearing age reveals the potential for HSV-2 transmission from mothers to infants and increased risk of acquisition HIV-infection; it also contributes to the burden GUD among both sexes. This emphasizes the public health implications of the HSV-2 epidemic in an urban population in North-West Russia.

Nodal Donovanosis as the Sentinel Clue to Acquired Immunodeficiency Syndrome

Abstract Objective: Donovanosis, caused by Calymmatobacterium granulomatis, is a recognized cause of genital ulcer disease. Extragenital donovanosis in acquired immunodeficiency syndrome (AIDS) and lymph nodes is documented rarely. The aim of this report is to highlight implications of lymph node involvement as the initial manifestation of donovanosis, especially in AIDS. Materials and methods: This is a retrospective clinicopathological 6 year study that reviewed the features of lymph node biopsies and patients presenting with nodal donovanosis. Results: Of a total of 198 patients with donovanosis, 4 patients with nodal disease were identified. Patient 1, on anti-tuberculous therapy for pulmonary tuberculosis for 2 weeks, developed subcutaneous nodules on her legs and left-sided inguinal lymphadenopathy. Biopsies confirmed erythema induratum and nodal donovanosis in the former and latter sites, respectively. Patients 2 and 3 presented with right-sided inguinal lymphadenopathy that simulated lymphoma. Lymph node biopsy confirmed donovanosis. Further examination on follow-up, confirmed ulcers on the cervix and penis, in patients 2 and 3, respectively. Biopsies of these genital ulcers demonstrated donovanosis in both patients. Patient 4 presented with a left-sided neck mass, biopsy of which confirmed nodal donovanosis. Subsequent biopsy of a pre-auricular ulcer and of the cervix confirmed donovanosis. HIV seropositivity and AIDS were confirmed in all patients. Patient 1 died of pulmonary tuberculosis while disease resolution was achieved in the others following 4-6 weeks of trimethoprim-sulfamethoxazole treatment. Conclusion: Heightened clinicopathological recognition of nodal donovanosis, lymph node biopsy and careful histomorphological assessment thereof are pivotal, not only for diagnostic confirmation of nodal donovanosis and its distinction from other common nodal infections, especially in the AIDS context, but also as a sentinel clue to genital donovanosis, HIV infection and AIDS.

P09.24 The aetiology of genital ulcer disease and association with hiv infection in zimbabwe

Background In many countries, sexually transmitted infections (STI) are treated syndromically. Thus, patients diagnosed with genital ulcer disease (GUD) in Zimbabwe receive antimicrobials that cover infections with Treponema pallidum (TP: benzathine penicillin), Haemophilus ducreyi (HD: erythromycin) and herpes simplex virus (HSV: acyclovir). However, periodic surveys into the aetiology of GUD are necessary to inform treatment guidelines. Methods For this study, we recently completed enrollment of 200 patients with GUD at 6 clinics in Zimbabwe. To date, test procedures have been completed for patients enrolled at Harare clinics (N = 70). Ulcer specimens were obtained for testing using a validated multiplex polymerase chain reaction assay (M-PCR, National Institute of Communicable Diseases, Johannesburg) for TP (primary syphilis), HD (chancroid), HSV (genital herpes) and Chlamydia trachomatis strains associated with lymphogranuloma venereum (CT-LGV). Blood samples were collected for HIV testing by a standard rapid HIV test algorithm (First Response™ followed by Alere HIV 1/2™) and considered positive when reactive on both. Results To date, M-PCR testing is complete for all 70 patients with GUD recruited from the Harare clinics (38 men and 32 women). Of these, 17 (24.2%) were positive for HSV, 8 (11.4%) were positive for TP, and 1 was positive for CT-LGV. No cases of chancroid were detected. The overall HIV positivity rate was 43.1%. HIV rates were higher among patients with HSV (62.5%, p = 0.07, Chi Square Test) and TP (87.5%, p Conclusions Genital herpes was the most common cause of GUD in our survey, followed by primary syphilis. The association of HIV infection with HSV and TP suggests high risk for co-transmission; however some HSV ulcerations among HIV-infected patients may be the result of HSV reactivation among immunocompromised patients. Our study methods and data should be relevant for other countries using a syndromic management to STI control.

Correlates to seroprevalent herpes simplex virus type 2 among rural Appalachian drug users

Herpes simplex virus type 2 (HSV-2) is the most common cause of genital ulcer disease and, along with substance abuse, an important HIV risk factor. Therefore, the purpose of this study was to examine HSV-2 seroprevalence in a sample of drug users in rural Appalachia. Rural Appalachian individuals age 18 or older reporting non-medical use of prescription opioids, heroin, crack/cocaine, or methamphetamine in the past 6 months (n = 499) were included. Behavioral, demographic, and sexual network data were collected using interviewer-administered questionnaires. Participants' serum was tested for HSV-2 antibodies using the Biokit rapid test (Lexington, MA). The estimated population seroprevalence of HSV-2 was 14.4% (95%CI: 9.6-19.4%). Only 8.8% were aware of being HSV-2+, and unprotected sex was reported in 80% of serodiscordant sexual relationships. In a multivariate model, female gender, age, older age at first oral sex, and frequency of unprotected sex in the sexual network were independently associated with HSV-2 seropositivity. Despite lower seroprevalence than that reported in similar studies of substance abusers, targeted interventions to reduce sexual risk behavior are warranted in this underserved population. Network-informed approaches with particular focus on women, older individuals, and those engaging in frequent unprotected sex are recommended.

Tenofovir Gel for the Prevention of Herpes Simplex Virus Type 2 Infection

BackgroundGlobally, herpes simplex virus type 2 (HSV-2) infection is the most common cause of genital ulcer disease. Effective prevention strategies for HSV-2 infection are needed to achieve the goals of the World Health Organization global strategy for the prevention and control of sexually transmitted infections.MethodsWe assessed the effectiveness of pericoital tenofovir gel, an antiviral microbicide, in preventing HSV-2 acquisition in a subgroup of 422 HSV-2–negative women enrolled in the Centre for the AIDS Programme of Research in South Africa (CAPRISA) 004 study, a double-blind, randomized, placebo-controlled trial. Incident HSV-2 cases were identified by evidence of seroconversion on an HSV-2 IgG enzyme-linked immunosorbent assay between study enrollment and exit. A confirmatory analysis was performed by Western blot testing.ResultsThe HSV-2 incidence rate was 10.2 cases per 100 person-years (95% confidence interval [CI], 6.8 to 14.7) among 202 women assigned to tenofovir gel, as compared with 21.0 cases per 100 person-years (95% CI, 16.0 to 27.2) among 222 women assigned to placebo gel (incidence rate ratio, 0.49; 95% CI, 0.30 to 0.77; P=0.003). The HSV-2 incidence rate among the 25 women with vaginal tenofovir concentrations of 10,000 ng per milliliter or more was 5.7 cases per 100 person-years, as compared with 15.5 cases per 100 person-years among the 103 women with no detectable vaginal tenofovir (incidence rate ratio, 0.37; 95% CI, 0.04 to 1.51; P=0.14). As confirmed by Western blot testing, there were 16 HSV-2 seroconversions among women assigned to tenofovir gel as compared with 36 among those assigned to the placebo gel (incidence rate ratio, 0.45; 95% CI, 0.23 to 0.82; P=0.005).ConclusionsIn this study in South Africa, pericoital application of tenofovir gel reduced HSV-2 acquisition in women. (Funded by the U.S. Agency for International Development and others; ClinicalTrials.gov number, NCT00441298.)

A Dual-Modality Herpes Simplex Virus 2 Vaccine for Preventing Genital Herpes by Using Glycoprotein C and D Subunit Antigens To Induce Potent Antibody Responses and Adenovirus Vectors Containing Capsid and Tegument Proteins as T Cell Immunogens.

We evaluated a genital herpes prophylactic vaccine containing herpes simplex virus 2 (HSV-2) glycoproteins C (gC2) and D (gD2) to stimulate humoral immunity and UL19 (capsid protein VP5) and UL47 (tegument protein VP13/14) as T cell immunogens. The HSV-2 gC2 and gD2 proteins were expressed in baculovirus, while the UL19 and UL47 genes were expressed from replication-defective adenovirus vectors. Adenovirus vectors containing UL19 and UL47 stimulated human and murine CD4(+) and CD8(+) T cell responses. Guinea pigs were either (i) mock immunized; (ii) immunized with gC2/gD2, with CpG and alum as adjuvants; (iii) immunized with the UL19/UL47 adenovirus vectors; or (iv) immunized with the combination of gC2/gD2-CpG/alum and the UL19/UL47 adenovirus vectors. Immunization with gC2/gD2 produced potent neutralizing antibodies, while UL19 and UL47 also stimulated antibody responses. After intravaginal HSV-2 challenge, the mock and UL19/UL47 adenovirus groups developed severe acute disease, while 2/8 animals in the gC2/gD2-only group and none in the combined group developed acute disease. No animals in the gC2/gD2 or combined group developed recurrent disease; however, 5/8 animals in each group had subclinical shedding of HSV-2 DNA, on 15/168 days for the gC2/gD2 group and 13/168 days for the combined group. Lumbosacral dorsal root ganglia were positive for HSV-2 DNA and latency-associated transcripts for 5/8 animals in the gC2/gD2 group and 2/8 animals in the combined group. None of the differences comparing the gC2/gD2-only group and the combined group were statistically significant. Therefore, adding the T cell immunogens UL19 and UL47 to the gC2/gD2 vaccine did not significantly reduce genital disease and vaginal HSV-2 DNA shedding compared with the excellent protection provided by gC2/gD2 in the guinea pig model. HSV-2 infection is a common cause of genital ulcer disease and a significant public health concern. Genital herpes increases the risk of transmission and acquisition of HIV-1 infection 3- to 4-fold. A herpes vaccine that prevents genital lesions and asymptomatic genital shedding will have a substantial impact on two epidemics, i.e., both the HSV-2 and HIV-1 epidemics. We previously reported that a vaccine containing HSV-2 glycoprotein C (gC2) and glycoprotein D (gD2) reduced genital lesions and asymptomatic HSV-2 genital shedding in guinea pigs, yet the protection was not complete. We evaluated whether adding the T cell immunogens UL19 (capsid protein VP5) and UL47 (tegument protein VP13/14) would enhance the protection provided by the gC2/gD2 vaccine, which produces potent antibody responses. Here we report the efficacy of a combination vaccine containing gC2/gD2 and UL19/UL47 for prevention of genital disease, vaginal shedding of HSV-2 DNA, and latent infection of dorsal root ganglia in guinea pigs.

Seroprevalence and Factors Associated with Herpes Simplex Virus Type 2 and Chlamydia trachomatis among Women Attending AIDS Care Unit at the Bonassama District Hospital

Background: Infections with Herpes Simplex Virus Type-2 (HSV-2) and Chlamydia trachomatis is the most common cause of genital ulcer disease and cervicitis worldwide. There is little information on the prevalence of these sexually transmitted infections (STIs) in Cameroon. The aim of this Original Research Article Luther et al.; BJMMR, 7(3): 224-230, 2015; Article no. BJMMR.2015.327 225 study was to evaluate the seroprevalence and behavior factors associated with Chlamydia trachomatis and HSV-2 seropositvity among women attending AIDS care unit in the district hospital in Douala. Methodology: One hundred and fifty seven consenting women (80 HIV-1 positive and 77 HIV-1 negative) were invited to participate in this study. A structured questionnaire was used for each woman to obtain informations about socio-demographic characteristics and sexual risk behavior. Peripheral venous blood sample were collected, labeled and sent to the laboratory, where the presence of IgG antibody against HSV-2 and Chlamydia trachomatis was detected, using ELISA test. Data management was carried out using the SPSS 16.0 statistical software. Results: The mean age of women was 37.22±9.13 years (range, 20 to 74 years). Of the 157 women tested, 122 (77.7%) were HSV-2 positive and 60 (38.2%) were positive for chlamydial infection. The prevalence of HSV-2 and chlamydial infections in HIV positive patients were 73.7% and 43.7% respectively versus 81.8% and 32.5% in HIV negative individuals. Women with multiple infections were those belonging to the group aged 30-39 years old, single and having had more than three sexual partners during the six months preceding the study. Conclusion: HIV status appears tobe a factor in the acquisition of chlamydial infection in our population. These results suggest the need for extension and expansion of the current study in Cameroon.

Current status and prospects for development of an HSV vaccine

Herpes simplex virus type 2 (HSV-2) infects 530million people, is the leading cause of genital ulcer disease, and increases the risk of HIV-1 acquisition. Although several candidate vaccines have been promising in animal models, prophylactic and therapeutic vaccines have not been effective in clinical trials thus far. Null results from the most recent prophylactic glycoprotein D2 subunit vaccine trial suggest that we must reevaluate our approach to HSV-2 vaccine development. We discuss HSV-2 pathogenesis, immunity, and vaccine efforts to date, as well as the current pipeline of candidate vaccines and design of trials to evaluate new vaccine constructs.

P2.180 TMR5 (ZedupexTM) as a Management Therapy For Herpes Infections: Results of Preclinical Evaluations

TMR5 (ZedupexTM) is a product of a Kenyan medicinal plant, prepared as a lyophilized extract and a cream. The products have been evaluated for preclinical safety and efficacy in suitable...

S12.2 Tales of Woe: HSV Vaccine and Null Study Results

Herpes simplex virus type 2 (HSV-2) infects 530 million people, is the predominant cause of genital ulcer disease, and a key driver of HIV epidemic in subSaharan Africa. In human...