Ocular Herpe implex: Changing Epidemiology, Emerging Dieae Pattern, and the Potential of Vaccine Prevention and Therapy Original Reearch Article

Purpoe To review the changing epidemiology of herpe implex viru infection, emerging pattern of herpetic ocular dieae, and the challenge and promie of herpe implex viru vaccine therapy. Deign Perpective. Method Literature review. Reult An epidemic increae in genital herpe implex type 2 infection i reflected in a 30% increae in HV-2 antibodie in the United tate ince 1976. Approximately one in four people in the United tate over age 30 i infected with HV-2. Primary acquiition of herpe implex type 1 i becoming progreively delayed in many indutrialized countrie, in contrat to developing nation where the viru i acquired early in life and i ubiquitou. Change in exual behavior among young adult have been aociated with a recent increae in genital HV-1 infection, reulting from oral-genital rather than genital-genital contact. Clinical trial of HV vaccine uing elected herpe implex viru type 2 protein mixed in adjuvant have hown limited efficacy in eronegative women, but not in men. Concluion The recent epidemic of genital herpe implex type 2 infection i likely to reult in an increae in neonatal ocular herpe and in delayed cae of acute retinal necroi yndrome. The increae in genital HV-1 may lead to indutry production of vaccine that contain component of both HV-1 and HV-2 targeted toward limiting genital dieae and tranmiion. A newer herpe implex vaccine become available, ophthalmologit mut be vigilant that a boot in immunity againt HV doe not have a paradoxical effect in exacerbating break-through cae that develop immune-mediated herpe implex tromal keratiti.