Frequency of Symptomatic and Asymptomatic Herpes Simplex Virus Type 2 Reactivations among Human Immunodeficiency Virus—Infected Men

• Published in: The Journal of infectious diseases Vol. 178; no. 6; pp. 1616 - 1622
• Main Authors: Schacker, Timothy, Zeh, Judith, Hu, Hui-lin, Hill, Edgar, Corey, Lawrence
• Format: Journal Article
• Language: English
• Published: Chicago, IL University Chicago Press 01.12.1998; University of Chicago Press; Oxford University Press
• Subjects: Acyclovir - therapeutic use; Adult; Aged; Anatomy; Antibodies, Viral - blood; Antiviral Agents - therapeutic use; Biological and medical sciences; CD4 Lymphocyte Count; Confidence Intervals; Epidemiology; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; Genitalia; Genitalia, Male - virology; Herpes Genitalis - complications; Herpes Genitalis - epidemiology; Herpes Genitalis - immunology; Herpesvirus 1, Human - immunology; Herpesvirus 2, Human - growth & development; Herpesvirus 2, Human - immunology; Herpesvirus 2, Human - isolation & purification; HIV; HIV 1; HIV Infections - complications; HIV Infections - immunology; HIV Seronegativity - immunology; Homosexuality, Male; Human herpesvirus 1; Human herpesvirus 2; Human viral diseases; Humans; Infections; Infectious diseases; Lesions; Major Article; Male; Medical sciences; Microbiology; Middle Aged; Mouth - virology; Odds Ratio; Rectum - virology; Recurrence; Risk Factors; Simplexvirus; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Virology; Virus Activation; Virus Shedding; Viruses; United States; North America; Washington; America; Human; Immunopathology; Opportunistic infection; Reactivation; Prevalence; Herpesviridae; Alphaherpesvirinae; Herpes; Male; AIDS; Serology; Immune deficiency; Epidemiology; Infection; Virus; Symptomatology; Herpesvirus hominis 2; Viral disease; Male genital diseases; Anorectal disease
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/314486

Herpes simplex virus (HSV) infection is common in persons coinfected with human immunodeficiency virus (HIV). In a prospective study, daily viral cultures of the mouth, genitals, and rectum were collected from 68 HIV-positive and 13 HIV-negative men who have sex with men. Subjects completed a median of 57 days of follow-up. Anogenital HSV-2 cultures were positive on 405 (9.7%) of 4167 days for HIV-positive men and on 24 (3.1%) of 766 days for HIV-negative men. Most reactivations were perirectal and subclinical. Risk factors for increased HSV-2 shedding among HIV-positive men were low CD4 cell count (odds ratio, 2.5; 95% confidence interval, 1.2–5.4) and antibodies to both HSV-1 and HSV-2 versus HSV-2 only (odds ratio, 1.9; 95% confidence interval, 1.0–3.7). Three isolates obtained from 3 separate subjects were resistant to acyclovir. Thus, subclinical HSV-2 reactivation is an important opportunistic infection in persons with HIV infection. Further studies are necessary to determine the impact of subclinical HSV-2 reactivation on the natural history of HIV infection.