Therapeutic Vaccine For Genital Herpes Simplex Virus-2 Infection: Findings From A Randomized Trial

Background. Genital herpes simplex virus type 2 (HSV-2) infection causes recurrent lesions and frequent viral shedding. GEN-003 is a candidate therapeutic vaccine containing HSV-2 gD2 Delta TMR and ICP4.2, and Matrix-M2 adjuvant.Methods. Persons with genital herpes were randomized into 3 dose cohorts to receive 3 intramuscular doses 21 days apart of 10 mu g, 30 mu g, or 100 mu g of GEN-003, antigens without adjuvant, or placebo. Participants obtained genital swab specimens twice daily for HSV-2 detection and monitored genital lesions for 28-day periods at baseline and at intervals after the last dose.Results. One hundred and thirty-four persons received all 3 doses. Reactogenicity was associated with adjuvant but not with antigen dose or dose number. No serious adverse events were attributed to GEN-003. Compared with baseline, genital HSV-2 shedding rates immediately after dosing were reduced with GEN-003 (from 13.4% to 6.4% for 30 mu g [P < .001] and from 15.0% to 10.3% for 100 mu g [P < .001]). Lesion rates were also significantly (P < .01) reduced immediately following immunization with 30 mu g or 100 mu g of GEN-003. GEN-003 elicited increases in antigen binding, virus neutralizing antibody, and T-cell responses.Conclusions. GEN-003 had an acceptable safety profile and stimulated humoral and cellular immune responses. GEN-003 at doses of 30 mu g and 100 mg reduced genital HSV shedding and lesion rates.