Therapeutic Vaccine for Genital Herpes Simplex Virus-2 Infection: Findings From a Randomized Trial

J Infect Dis. 2017 Mar 15;215(6):856-864. doi: 10.1093/infdis/jix004.

Abstract

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∆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 µg, 30 µg, or 100 µg 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 μg [P < .001] and from 15.0% to 10.3% for 100 µg [P < .001]). Lesion rates were also significantly (P < .01) reduced immediately following immunization with 30 µg or 100 µg 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 µg and 100 µg reduced genital HSV shedding and lesion rates.

Clinical trials registration: NCT01667341 (funded by Genocea).

Keywords: GEN-003; Genital herpes; herpes simplex virus type 2 infection; therapeutic vaccine; immunotherapy.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Antibodies, Viral / blood
  • Female
  • Herpes Genitalis / drug therapy*
  • Herpes Genitalis / immunology*
  • Herpes Genitalis / prevention & control
  • Herpes Genitalis / virology
  • Herpesvirus 2, Human / immunology*
  • Humans
  • Immunoglobulin G / blood
  • Immunotherapy
  • Male
  • Middle Aged
  • Viral Vaccines / adverse effects
  • Viral Vaccines / immunology*
  • Viral Vaccines / therapeutic use*
  • Virus Shedding
  • Young Adult

Substances

  • Antibodies, Viral
  • Immunoglobulin G
  • Viral Vaccines

Associated data

  • ClinicalTrials.gov/NCT01667341