Genital Symptoms and Genital Hsv-2 and Hiv-1 Shedding In Co-Infected Women — Chiang Rai, Thailand

Brooke E Hoots ,Sara J Whitehead ,Lauri E Markowitz ,Janet M Mcnicholl ,Cheng Chen ,Thomas A Peterman ,Tammy Evans-Strickfaden ,Eileen F Dunne

doi:10.17303/jaid.2015.2.403

Abstract

1Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA 2Division of Applied Sciences, Epidemic Intelligence Service, Scientific Education and Professional Development Program Office, Centers for Disease Control and Prevention, Atlanta, GA, USA 3Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA 4Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, GA, USA 5Thailand Ministry of Public Health-US CDC Collaboration, Nonthaburi, Thailand Research Open Access

Highlights

Herpes simplex type 2 (HSV-2) infection is associated with increased HIV-1 infectiousness and transmission [1]
Compared to intervals when there were no symptoms or sores, swabs collected when women had symptoms in the three-day window prior were 2.0 times as likely to be positive for herpes simplex virus type 2 (HSV-2) DNA; this association was stronger when women had sores alone, at 2.7 and when they had sores and symptoms (PR: 2.8, 95% confidence interval (CI): 1.7-4.5)
It found that genital ulcer disease (GUD) and HSV-2 genital shedding were associated with higher plasma HIV viral load

Summary

Introduction

Herpes simplex type 2 (HSV-2) infection is associated with increased HIV-1 infectiousness and transmission [1]. HSV-2 might increase the risk of HIV transmission due to genital vesicles and ulcers, and shedding of HIV through these breaches in epithelial integrity [2]. Increased risk of HIV-1 transmission might be the result of increased HIV replication and shedding mediated by cytokine production and co-infection of HIV-infected cells [3,4,5]. Studies demonstrating increased HIV-1 transmission in the presence of HSV-2 infection have been primarily conducted in persons with genital ulcers who comprise a small proportion of all persons with HSV-2 infection. There are few studies examining HIV shedding during asymptomatic HSV-2 infection or in the presence of genital symptoms other than

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