Abstract
Increasing evidence demonstrates a substantial link between the epidemics of sexually transmitted HIV-1 and herpes simplex virus (HSV)-2 infection. More than 30 epidemiologic studies have demonstrated that prevalent HSV-2 is associated with a 2- to 4-fold increased risk of HIV-1 acquisition. Per-sexual contact transmission rates among couples from Rakai, Uganda indicate that at all levels of plasma HIV-1 RNA in the source partner, HSV-2-seropositive HIV-1-susceptible persons have a 5-fold greater risk of acquiring HIV-1 compared with HSV-2-negative persons. In vitro and in vivo studies suggest that mucosal HIV-1 shedding is more frequent and in greater amounts during mucocutaneous HSV-2 replication, including subclinical mucosal reactivations. Most HIV-1-infected persons are coinfected with HSV-2, and most experience frequent subclinical and clinical reactivations of HSV-2. Subclinical HSV reactivation elevates serum HIV-1 RNA levels, and daily therapy with acyclovir appears to reduce plasma HIV-1 RNA. These data show that greater attention to the diagnosis and treatment of HSV-2 among HIV-1-infected persons is warranted, especially those who continue to be sexually active, those not on antiretroviral therapy, or those whose disease is not well suppressed by antiretrovirals.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 435-445 |
| Number of pages | 11 |
| Journal | Journal of Acquired Immune Deficiency Syndromes |
| Volume | 35 |
| Issue number | 5 |
| DOIs | |
| State | Published - Apr 15 2004 |
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Keywords
- Genital herpes
- Herpes simplex virus infections
- HIV acquisition and transmission
ASJC Scopus subject areas
- Virology
- Immunology
Cite this
The Effects of Herpes Simplex Virus-2 on HIV-1 Acquisition and Transmission : A Review of Two Overlapping Epidemics. / Corey, Lawrence; Wald, Anna; Celum, Connie L.; Quinn, Thomas C.
In: Journal of Acquired Immune Deficiency Syndromes, Vol. 35, No. 5, 15.04.2004, p. 435-445.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The Effects of Herpes Simplex Virus-2 on HIV-1 Acquisition and Transmission
T2 - A Review of Two Overlapping Epidemics
AU - Corey, Lawrence
AU - Wald, Anna
AU - Celum, Connie L.
AU - Quinn, Thomas C
PY - 2004/4/15
Y1 - 2004/4/15
N2 - Increasing evidence demonstrates a substantial link between the epidemics of sexually transmitted HIV-1 and herpes simplex virus (HSV)-2 infection. More than 30 epidemiologic studies have demonstrated that prevalent HSV-2 is associated with a 2- to 4-fold increased risk of HIV-1 acquisition. Per-sexual contact transmission rates among couples from Rakai, Uganda indicate that at all levels of plasma HIV-1 RNA in the source partner, HSV-2-seropositive HIV-1-susceptible persons have a 5-fold greater risk of acquiring HIV-1 compared with HSV-2-negative persons. In vitro and in vivo studies suggest that mucosal HIV-1 shedding is more frequent and in greater amounts during mucocutaneous HSV-2 replication, including subclinical mucosal reactivations. Most HIV-1-infected persons are coinfected with HSV-2, and most experience frequent subclinical and clinical reactivations of HSV-2. Subclinical HSV reactivation elevates serum HIV-1 RNA levels, and daily therapy with acyclovir appears to reduce plasma HIV-1 RNA. These data show that greater attention to the diagnosis and treatment of HSV-2 among HIV-1-infected persons is warranted, especially those who continue to be sexually active, those not on antiretroviral therapy, or those whose disease is not well suppressed by antiretrovirals.
AB - Increasing evidence demonstrates a substantial link between the epidemics of sexually transmitted HIV-1 and herpes simplex virus (HSV)-2 infection. More than 30 epidemiologic studies have demonstrated that prevalent HSV-2 is associated with a 2- to 4-fold increased risk of HIV-1 acquisition. Per-sexual contact transmission rates among couples from Rakai, Uganda indicate that at all levels of plasma HIV-1 RNA in the source partner, HSV-2-seropositive HIV-1-susceptible persons have a 5-fold greater risk of acquiring HIV-1 compared with HSV-2-negative persons. In vitro and in vivo studies suggest that mucosal HIV-1 shedding is more frequent and in greater amounts during mucocutaneous HSV-2 replication, including subclinical mucosal reactivations. Most HIV-1-infected persons are coinfected with HSV-2, and most experience frequent subclinical and clinical reactivations of HSV-2. Subclinical HSV reactivation elevates serum HIV-1 RNA levels, and daily therapy with acyclovir appears to reduce plasma HIV-1 RNA. These data show that greater attention to the diagnosis and treatment of HSV-2 among HIV-1-infected persons is warranted, especially those who continue to be sexually active, those not on antiretroviral therapy, or those whose disease is not well suppressed by antiretrovirals.
KW - Genital herpes
KW - Herpes simplex virus infections
KW - HIV acquisition and transmission
UR - http://www.scopus.com/inward/record.url?scp=1842615043&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=1842615043&partnerID=8YFLogxK
U2 - 10.1097/00126334-200404150-00001
DO - 10.1097/00126334-200404150-00001
M3 - Article
VL - 35
SP - 435
EP - 445
JO - Journal of Acquired Immune Deficiency Syndromes
JF - Journal of Acquired Immune Deficiency Syndromes
SN - 1525-4135
IS - 5
ER -