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The herpes simplex problem.
1Department of Dermatology, University of North Carolina School of Medicine, North Carolina Memorial Hospital, Chapel Hill 27514.
Journal of the American Academy of Dermatology
|January 1, 1988
Summary
Herpes simplex virus infections are widespread and contagious, even when asymptomatic. Current treatments cannot eliminate latent virus, making eradication difficult and raising questions about vaccine efficacy.
Area of Science:
- Virology
- Epidemiology
- Public Health
Background:
- Herpes simplex virus types 1 and 2 infect most of the global population, establishing lifelong latent infections in nerve ganglia.
- Infections can be asymptomatic or clinical, with all forms being contagious and spread through close contact, fomites, or medical procedures.
- Previous estimates of recurrent herpes prevalence (20-40%) may be underestimated due to challenges in detecting asymptomatic shedding and genital recurrences.
Purpose of the Study:
- To highlight the challenges in controlling and eradicating herpes simplex virus infections.
- To discuss the limitations of current public health measures and antiviral therapies.
- To evaluate the potential role and limitations of vaccines in managing herpes simplex virus.
Main Methods:
- Review of existing literature on herpes simplex virus epidemiology, transmission, and clinical manifestations.
- Analysis of the persistence of latent virus and reactivation patterns.
- Discussion of the implications of reinfection and superinfection on disease control strategies.
Main Results:
- Latent herpes simplex virus, with frequent reactivation causing symptomatic or asymptomatic infectious disease, presents a significant obstacle to eradication.
- Antiviral drugs have not proven effective in eliminating latent virus from nerve ganglia.
- The potential for reinfection, superinfection, and autoinoculation in naturally infected individuals complicates the development of effective vaccines for complete eradication.
Conclusions:
- Public health measures for herpes simplex virus control are likely to be ineffective due to the required lifestyle changes.
- Vaccines may offer some control over severe manifestations and limit transmission but are unlikely to eradicate the disease due to the nature of latent infections and recurrences.
- Eradicating herpes simplex virus poses unique challenges compared to diseases like smallpox, primarily due to the existence of latent infections with recurrent infectious episodes.