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To the Editor: Dr Corey and colleagues¹ reported that a recombinant glycoprotein vaccine failed to prevent genital herpes simplex virus 2 (HSV-2) infection. The study evaluated asymptomatic and symptomatic infections and symptomatic recurrences. None of these outcomes were modified by vaccine despite neutralizing and antibody titers that exceeded those produced during naturally acquired HSV-2 infection. The authors suggest that more information is needed about cellular and mucosal immune responses to HSV-2 infection before "we can attempt to identify laboratory-based correlates of immune protection." While more information would be helpful, the authors failed to consider currently available information that is relevant to the vaccine failure.

In recent years we have learned that viruses have evolved both offensive and defensive strategies. Viral proteins use cellular receptors for entry and manipulate cell death signals as part of their offensive strategies, while they encode proteins to counteract host immunity as part of their defense. . . . [Full Text of this Article]

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RELATED ARTICLE

Recombinant Glycoprotein Vaccine for the Prevention of Genital HSV-2 Infection: Two Randomized Controlled Trials
Lawrence Corey, Andria G. M. Langenberg, Rhoda Ashley, Rose E. Sekulovich, Allen E. Izu, John M. Douglas, Jr, H. Hunter Handsfield, Terri Warren, Lisa Marr, Stephen Tyring, Richard DiCarlo, Adaora A. Adimora, Peter Leone, Cornelia L. Dekker, Rae Lyn Burke, Wai Ping Leong, Stephen E. Straus, and for the Chiron HSV Vaccine Study Group
JAMA. 1999;282(4):331-340.
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