Frequent recovery of HIV-1 from genital herpes simplex virus lesions in HIV-1-infected men.
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.
Schacker
T
T
Department of Medicine, University of Washington, Seattle, USA.
Ryncarz
A J
AJ
Goddard
J
J
Diem
K
K
Shaughnessy
M
M
Corey
L
L
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
D012367:RNA, Viral