How is herpes simplex virus (HSV) infection prevented?

Updated: Mar 17, 2020
  • Author: Sean P McGregor, DO, PharmD; Chief Editor: William D James, MD  more...
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Answer

Herpes simplex virus (HSV) viral shedding is greatest during clinically evident outbreaks; however, transmission from individuals who are seropositive to their partners who are seronegative usually occurs during asymptomatic periods of viral shedding. Therefore, preventing transmission requires more than abstaining from intimate contact during outbreaks.

The prevention of herpes labialis is focused on the avoidance of triggers and prophylaxis in certain scenarios. UV light exposure, specifically UVB, can lead to recurrences of herpes labialis, and sunscreen can help prevent recurrences. [68] Laser resurfacing has been shown to cause recurrences in 2.2% of patients, and prophylaxis with systemic antivirals may reduce the risk of recurrence. [69, 70]

Barrier methods, such as condoms, confer 10-15% protection against the transmission of genital herpes, as transmission can occur to and from uncovered mucocutaneous surfaces or if the integrity of the barrier is compromised. Condoms have also been shown to be more effective in protecting women than men.

Various HSV vaccines have been and continue to be under investigation for the treatment and prevention of herpes genitalis, although most have not been shown to be effective. [71] A trivalent glycoprotein C, D, and E vaccine has been evaluated in guinea pigs, and a 50% reduction in the frequency of recurrences and vaginal shedding of HSV was observed. [72] Double-blind randomized trials of a glycoprotein D HSV-2 vaccine revealed that the vaccine conferred protection against the virus in women who were serologically negative for both HSV-1 and HSV-2. However, it did not prevent HSV infection in men, despite their serostatus, or in women who were positive for HSV-1 but negative for HSV-2. [73] In 2017, a glycoprotein D monoclonal antibody that can block in vitro cell-to-cell spread of HSV was developed, with implications for the prevention and treatment of HSV infection. [74]


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