Targeting virological core groups: A new paradigm for controlling herpes simplex virus type 2 epidemics

Sally Blower, Anna Wald, Hayley Gershengorn, Fei Wang, Larry Corey

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Background. Classic modeling of sexually transmitted diseases has focused on modeling behavioral heterogeneity and designing epidemic control strategies targeted at behavioral core groups. Methods. We analyzed a new mathematical model of herpes simplex virus type 2 (HSV-2) epidemics that includes virological core groups (i.e., groups of individuals with high rates of viral reactivation) and suggest a new paradigm for epidemic control. We used our model, in conjunction with virological data, to determine the potential role of virological core groups in contributing to transmission and the effect that daily antiviral therapy (DAT) could have on reducing transmission if virological core groups were targeted. Results. We estimated that a virological core group (11% of infected individuals) can cause a disproportionately large percentage (44%) of new infections and that a median of only 6.4 person-years of DAT would be necessary to prevent 1 HSV-2 infection. We determined that relatively few individuals would need to receive DAT to substantially reduce the incidence of HSV-2 infection. Conclusion. Identifying and targeting individuals in the virological core group could be an effective and practical public health strategy for reducing transmission. Treating individuals who are high-frequency viral shedders should be evaluated as a strategy for reducing HSV-2 transmission.

Original languageEnglish (US)
Pages (from-to)1610-1617
Number of pages8
JournalJournal of Infectious Diseases
Issue number9
StatePublished - Nov 1 2004
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)


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