title: Frequent recovery of HIV-1 from genital herpes simplex virus lesions in HIV-1-infected men.
abstract: BACKGROUND
  Genital ulcer disease has been epidemiologically linked as a risk factor in the transmission of the human immunodeficiency virus 1 (HIV-1). While herpes simplex virus 2 (HSV-2) is the most common cause of genital ulcers, no study has systematically evaluated the frequency or titer of HIV-1 virus in HSV-2 lesions.
  
  
  OBJECTIVE
  To compare lesional HIV-1 RNA levels during and after genital HSV-2 reactivation and to evaluate the frequency, titer, and duration of HIV-1 RNA shedding in lesions due to HSV-2.
  
  
  METHODS
  Convenience sample.
  
  
  METHODS
  Sexually transmitted disease research clinic at the University of Washington, Seattle.
  
  
  METHODS
  Twelve HIV-infected men with a history of symptomatic HSV-2 infection who underwent daily sampling of genital lesions for HIV-1 RNA by polymerase chain reaction assay and HSV-2 by culture.
  
  
  METHODS
  Detection of lesional HIV RNA and HSV-2.
  
  
  RESULTS
  HIV-1 RNA was detected from lesional swabs in 25 of 26 consecutively studied HSV-2 episodes and on 67% of days in which genital lesions were noted. The HIV-1 RNA titers in lesional swabs exceeded 10000 copies/mL of swab sample in 75% of samples (range, 2.2-3.2 x 10(5) copies/mL of swab sample). HIV-1 RNA in genital lesion swabs was seen in persons with high and low titers of plasma HIV-1 RNA and was not associated with plasma HIV-1 RNA levels.
  
  
  CONCLUSIONS
  HIV-1 virions can consistently be detected in genital ulcers caused by HSV-2, which suggests that genital herpes infection likely increases the efficiency of the sexual transmission of HIV-1.
authors.affiliation: Department of Medicine, University of Washington, Seattle, USA.
authors.forename: T
authors.initials: T
authors.lastname: Schacker
authors.forename: A J
authors.initials: AJ
authors.lastname: Ryncarz
authors.forename: J
authors.initials: J
authors.lastname: Goddard
authors.forename: K
authors.initials: K
authors.lastname: Diem
authors.forename: M
authors.initials: M
authors.lastname: Shaughnessy
authors.forename: L
authors.initials: L
authors.lastname: Corey
mesh_terms: D000328:Adult; D015658:HIV Infections / Q000150:complications* / Q000635:transmission*; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification*; D006558:Herpes Genitalis / Q000150:complications* / Q000821:virology; D018258:Herpesvirus 2, Human / Q000302:isolation & purification; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000032:analysis; D012307:Risk Factors; D017201:Virus Shedding
chemical_list: D012367:RNA, Viral