The effects of herpes simplex virus-2 on HIV-1 acquisition and transmission: A review of two overlapping epidemics

摘要: 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 2- to 4-fold increased risk acquisition. Per-sexual contact transmission rates among couples from Rakai, Uganda indicate at all levels plasma RNA in source partner, HSV-2-seropositive HIV-1-susceptible persons 5-fold greater acquiring compared HSV-2-negative persons. In vitro vivo suggest mucosal shedding more frequent amounts during mucocutaneous replication, including subclinical reactivations. Most HIV-1-infected are coinfected HSV-2, most experience clinical reactivations HSV-2. Subclinical HSV reactivation elevates serum levels, daily therapy acyclovir appears reduce RNA. These data show attention diagnosis treatment warranted, especially those who continue be active, not on antiretroviral therapy, or whose disease well suppressed by antiretrovirals.