Development of prophylactic vaccines for genital and neonatal herpes.

Over five decades numerous conventional candidate live attenuated and killed vaccines have failed to prevent genital herpes in clinical trials. However, a vaccine consisting of recombinant glycoprotein D from herpes simplex virus (HSV)-2 and deacylated monophosphoryl lipid A adjuvant has recently shown partial efficacy against clinical disease transmitted from HSV-1 and -2 seronegative women (73-74%). Comparisons between the efficacy of this vaccine and previous failed candidates and their effects on the immune system should help guide development of better vaccines through selection of appropriate HSV proteins, adjuvants or cytokines and newer vaccine vectors, such as DNA vaccines, recombinant viral vaccines and specific HSV mutants.