Every single second around the world, someone is infected with genital herpes. This adds up to 42 million new cases a year, and about 200 additional people affected by the time you finish reading this post. This startling statistic was released by the World Health Organization earlier this week.
Genital herpes is a common sexually transmitted infection, caused by the herpes simplex virus (HSV). Its expression varies from no symptoms, through mild ones to recurrent genital ulcers. Once contracted, the virus is lifelong, remaining latent or inactive in one's nerve cells between recurrent outbreaks of ulcers. Currently, there is no cure.
HSV belongs to the human Herpesviridae family, consisting of other common DNA viruses such as Epstein-Barr virus (EBV), Cytomegalovirus (CMV) and Varicella-Zoster virus. Both known types, HSV-1 and HSV-2, can cause genital warts, though the latter is its leading cause, while HSV-1 is typically acquired earlier in life, commonly manifested as cold sores or mouth ulcers.
The newly published study, conducted by the WHO and fellow researchers, devised a mathematical model to analyze global data on new and existing cases in 2020, updating previous statistics. Researchers found that more than one in five adults aged 15 to 49 years are living with genital herpes worldwide. This high clinical and psychological burden also yields significant economic costs, with a recent study estimating over 35 billion dollars in annual expenditures in 2016. HSV-2 has also been linked to an increased risk of HIV infection.
Different antiviral medications exist to alleviate the severity of symptoms and reduce their frequency, while safe sex practices can decrease risk of transmission. Nonetheless, no cure has been discovered yet. This is particularly significant for people with compromised immune systems, in whom severe complications are far more common.
Efforts to develop vaccines have been underway for more than half a century, but have so far been unsuccessful. This is likely due to HSV's dormancy and its ability to evade the immune system, more advanced than other herpesvirus infection, such as chickenpox and shingles, against which vaccines exist.
Two main strategies to eradicate the virus exist: prophylactic vaccines, to prevent initial infection, and therapeutic vaccines, to help people already infected. Several candidates are currently being evaluated at different development stages.
A potential game changer is gene editing. A recent study published by researchers from the Fred Hutch Cancer Center, introduced a novel and potentially curative approach to fighting the virus: targeted HSV gene editing. This technique uses vector molecules that seek the virus and target it, combined with enzymes that disrupt the virus' DNA beyond repair, only to then be recognized by the body's own immune system for the final clean-up. This avenue has thus far been tested in animal models, and against HSV-1 only.
There is no doubt that genital herpes should be recognized as one of the most common and frequently encountered diagnoses. As such, education and prevention efforts should be prioritized, alongside creative and groundbreaking science to address this 'hidden epidemic.'