THE PREVALENCE and current type mix of genital herpes simplex virus (HSV) infections worldwide, along with growing awareness of virus reactivation, call for new prevention and treatment approaches, including polyfunctional antibodies, vaccines, and gene-editing techniques.
More than four billion people globally have genital herpes, either herpes simplex virus Type 1 (HSV-1) or Type 2 (HSV-2), noted a review of epidemiology and research.
According to World Health Organization data for 2020, a source cited in the review, an estimated 25.6 million people aged 15–49 years developed new HSV-2 infections, and there were 519.5 million prevalent HSV-2 infections. The same year, there were 16.8 million new cases of people aged 15–49 years developing HSV-1 genital infections, which are typically caused by contact with cold sores, and 376.2 million with prevalent HSV-1 infections.
HSV-1: On the Rise in Genital Herpes
In the past, genital herpes was usually caused by HSV-2 infection. But HSV-1, which is typically caused by contact with cold sores, is now a common cause of genital herpes, accounting for more than half of all new infections worldwide, noted authors of the review.
HSV-1 is less likely than HSV-2 to cause clinical recurrences, and both types can be transmitted perinatally, the authors noted. Patients with both types are often asymptomatic and can unknowingly spread infection and develop problems that emerge later in life.
With the advent of molecular diagnostics. came knowledge that herpes simplex virus reactivation is more common than previously thought, and fresh treatment ideas are needed. Today, patients are treated with oral antivirals to suppress HSV infection and lessen symptoms during outbreaks, but the infection is not cured and can be transmitted. Also, resistance is a concern.
Emerging Strategies for Prevention and Treatment
The review authors concluded that prior vaccine trial failures and recent research suggest that neutralizing antibodies, long thought to indicate protection, are not sufficient on their own. Effective prophylactic and therapeutic vaccines will likely require polyfunctional antibodies with cytolytic activity, as well as robust cellular immune responses.
Gene editing using adeno-associated virus vectors and CRISPR/Cas methods represent another promising area of development.
Reference:
Collins-Oglea M and Herold BC. Developments in genital herpes: progress in prevention and treatment: Curr Opin Infect Dis. 2025;DOI:10.1097/QCO.0000000000001177.
