A herpes simplex virus 2 (HSV-2) glycoprotein E deletion mutant (gE2-del virus) was evaluated as a replication-competent, attenuated live virus vaccine candidate. The gE2-del virus is defective in epithelial cell-to-axon spread and in anterograde transport from the neuron cell body to the axon terminus. In BALB/c and SCID mice, the gE2-del virus caused no death or disease after vaginal, intravascular, or intramuscular inoculation and was 5 orders of magnitude less virulent than wild-type virus when inoculated directly into the brain. No infectious gE2-del virus was recovered from dorsal root ganglia (DRG) after multiple routes of inoculation; however, gE2-del DNA was detected by PCR in lumbosacral DRG at a low copy number in some mice. Importantly, no recurrent vaginal shedding of gE2-del DNA was detected in immunized guinea pigs. Intramuscular immunization outperformed subcutaneous immunization in all parameters evaluated, although individual differences were not significant, and two intramuscular immunizations were more protective than one. Immunized animals had reduced vaginal disease, vaginal titers, DRG infection, recurrent genital lesions, and recurrent vaginal shedding of HSV-2 DNA; however, protection was incomplete. A combined modality immunization using live virus and HSV-2 glycoprotein C and D subunit antigens in guinea pigs did not totally eliminate recurrent lesions or recurrent vaginal shedding of HSV-2 DNA. The gE2-del virus used as an immunotherapeutic vaccine in previously HSV-2-infected guinea pigs greatly reduced the frequency of recurrent genital lesions. Therefore, the gE2-del virus is safe, other than when injected at high titer into the brain, and is efficacious as a prophylactic and immunotherapeutic vaccine. H erpes simplex virus 1 and 2 (HSV-1 and HSV-2) cause common infections worldwide (33, 47). HSV-1 typically causes vesicles and ulcers on the vermillion border of the lip, and HSV-2 causes genital ulcers. HSV-1 and HSV-2 transmission occurs by contact with infected individuals, with HSV-1 acquisition typically beginning in childhood and HSV-2 acquisition occurring at the onset of sexual activity.HSV-1 and HSV-2 have similar infection cycles, replicating initially in epithelial cells and spreading to sensory neurons of the peripheral nervous system. After the virus enters axons, it travels retrograde to the neuron cell body, where latency is established, followed by periodic reactivation. During recurrences, HSV travels along neurons in the anterograde direction to the dermatome innervated by the infected ganglion. Replication within the epithelium results in either asymptomatic virus shedding or lesions. Initial episodes of genital ulcer disease are as likely to be caused by HSV-1 as HSV-2; however, recurrences are considerably more common after HSV-2 infection (15,23,43). Serious sequelae of genital ulcer disease include infection of neonates during labor and delivery and a 3-fold increased risk of acquiring HIV-1 infection (10)(11)(12)44).A vaccine to prevent HSV-2 is a high public...