Worldwide, the herpes simplex virus (HSV) affects two-thirds of people under the age of 50.

Right now, antiviral drugs are the only treatment approved by the Food and Drug Administration (FDA) that people can take to fight HSV.

But that could change in the coming years.

Two companies are developing treatments for the virus that could change the game completely.

“Everything looks pretty promising,” Dr. Jamin Brahmbhatt, a urologist at Orlando Health in Florida, told Healthline. “There are two companies competing head to head to see who can get the vaccine out first, and they both have different ways of getting their vaccine out. So I thought it was very interesting to see the dollars they’ve committed to the research and the ways they’re trying to get it out for human use as soon as possible.”

Understanding herpes

It’s worth noting that HSV is different than the human papillomavirus (HPV).

First, the two viruses evolve differently.

Also, HSV comes with a host of symptoms, including blisters, itching, and red bumps.

HPV, on the other hand, often causes no symptoms at all.

“Herpes is a very smart bug,” explained Brahmbhatt. “With most vaccines, the way they work is they use your immune system to basically build a tolerance against, or an immunity against, whatever you’re exposed to with the vaccine… Herpes has kind of learned ways to bypass your immune system. So it’s a lot more difficult to target when it comes to vaccines.”

However, HSV and HPV also share some commonalities.

They can both be difficult to treat.

They’re also widespread, affecting millions of people in the United States and billions around the world.

But while there’s a vaccine available in the United States able to treat HPV, there isn’t one available to treat HSV.

“It’s [HSV] very prevalent, and I’d say the numbers are probably higher than the statistics would indicate,” said Brahmbhatt. “And that’s why there’s a big focus on — number one — how can we prevent someone from contracting the actual virus to avoid some of these complications? And — number two — if you’ve contracted the virus already, what can we do to control the symptoms? Because all we have right now is one class of medication that helps control the symptoms. But is there a way that we can do that better? Those are the mentalities that are going into finding some sort of vaccine.”

Two companies, two approaches

Brahmbhatt described two companies currently working on drugs to treat HSV.

“One company, Genocea, just finished their phase II trials, and they’re about to go through phase III trials. If you look at their phase II data, they reported a 50 percent reduction compared to a placebo. In 2017 or 2018, they’ll go through phase III, so if everything goes well for them then, it may be two or three years before it can actually be used by the public.”

Rational Vaccines, the second company, announced late last year the results of their phase I clinical trial of a drug called Theravax.

Besides Theravax, Rational Vaccines is also working on a herpes drug called Profavax.

“Theravax would essentially be a therapy, as an alternative to the current antiviral medication, whereas Provax would be for prevention,” said Brahmbhatt. “That means a patient could take Provax and prevent ever getting the virus.”

Despite this progress, both companies have encountered stumbling blocks.

While Genocea’s phase II trials showed promise, some patients in the trial didn’t respond as well as expected to the vaccine.

Rational Vaccines, on the other hand, has courted controversy by forgoing the traditional FDA testing process.

“They actually bypassed America completely and tested their vaccine on the island of St. Kitts,” explained Brahmbhatt. “And now what they’re trying to do is get approval in Mexico and Canada, and basically bypassing the system. If it works out well, they could eventually bring it to the United States legally.”

Comparing the two companies, Brahmbhatt said, “It’s two different rationales. They’re both headed in the right direction and showing data indicating that there is a benefit.”

“They’ve found unique, proprietary ways to fight the herpes virus,” he added. “I think it’s pretty cool, the commitment they’ve made the last few years, and it’ll be interesting to see where it goes.”