Recurrence is characteristic of herpes. Unfortunately, even upon successful recovery from the initial outbreak, there is no knowing for sure whether herpes will return or not. Our experience (A.A. Kasparov, 2005) shows that the risk of recurrence after the first attack is 33%, which means that one out of three patients will develop herpes simplex keratitis again sometime in the future. After the first recurrence, the risk of subsequent recurrences is even greater (50%).
How is this issue addressed in the world? Patients with a history of recurrence have no other option but to receive maintenance doses of Acyclovir on a constant basis. Just like any other chemotherapy drug, Acyclovir is rather toxic and has a negative effect on the liver and kidneys, organs in charge of removing waste and byproducts from the body. This is not without a cost to overall health. Moreover, the drug is quite expensive. And last but not least, Acyclovir does not actually offer a solution to the problem of recurrence, and once the drug is discontinued, herpes returns.
All this means that globally the issue of herpes recurrence remains unsolved.
That said, our country developed an antiherpetic vaccine and has been using it for 40 years. The vaccine is the third crucial component of A. A. Kasparov’s approachto herpes treatment.
A.K. Shubladze and T.M. Mayevskaya began developing the antiherpetic vaccine in the USSR in the early 1960s. In 1966, they created the first experimental vaccine based on several most common HSV strains with high immunogenic potential.
Researchers and clinicians spent the subsequent years on defining vaccination protocols (dosage, number and frequency of vaccinations, additional medications) and matching them to different stages of the disease.
In 1972, professor A.A. Kasparov and his team of ophthalmologists and virologists published the results of their clinical trials. The data was used to develop additional indications (preventive vaccination between herpes outbreaks for patients with frequent recurrences) and protocols for combined treatment (antiherpetic vaccine + topical preventive interferon inducers, e.g., Poludan or Pyrogenal).
Experimental trials were conducted on animal models (rabbits) and a carefully selected group of patients (n=114) with frequent recurrences of ocular herpes. Additional information on the study is available in professor A.A. Kasparov’s monograph titled “Офтальмогерпес” (Oftalmogerpes, in Rus.).
Among the many available vaccination protocols, the most popular one implies a series of injections over a period of complete absence of inflammation signs with subsequent courses every 4-6 months. A vaccination series consists of 5 intradermal injections of the antiherpetic vaccine (0.05-0.3 ml) into the flexor surface of the forearm. After each administration, the dermahemia area at the injection site is measured.
Six to eight courses of antiherpetic vaccination result in dramatic decline of recurrence rates. This basically means 5 injections into the forearm every 6 months over the period of 3 years.
Research indicated that 62% of patients no longer experienced recurrences, in 28% of cases recurrences became less frequent and only 10% of patients had no improvement in frequency. Statistical analysis showed that on average, the frequency and duration of recurrences decreased 5 and 3.2 times respectively.
A combination of Poludan and antiherpetic vaccine stimulates the immune system and keeps the virus in check.
The antiherpetic vaccine is another unique component of our approach to herpes management.