Frequency of symptomatic and asymptomatic herpes simplex virus type 2 reactivations among human immunodeficiency virus-infected men.
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 necessaryto determine the impact of subclinical HSV-2 reactivation on the natural history of HIV infection.
Schacker
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Department of Medicine, University of Minnesota, Minneapolis, MN 55455, USA. schac008@Linti.med.umn.edu
Zeh
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Hu
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HL
Hill
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Corey
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D000212:Acyclovir / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D016001:Confidence Intervals; D005500:Follow-Up Studies; D005837:Genitalia, Male / Q000821:virology; D015658:HIV Infections / Q000150:complications* / Q000276:immunology; D018023:HIV Seronegativity / Q000276:immunology; D006558:Herpes Genitalis / Q000150:complications* / Q000453:epidemiology* / Q000276:immunology; D018259:Herpesvirus 1, Human / Q000276:immunology; D018258:Herpesvirus 2, Human / Q000254:growth & development* / Q000276:immunology / Q000302:isolation & purification; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000821:virology; D016017:Odds Ratio; D012007:Rectum / Q000821:virology; D012008:Recurrence; D012307:Risk Factors; D014775:Virus Activation; D017201:Virus Shedding
D000914:Antibodies, Viral; D000998:Antiviral Agents; D000212:Acyclovir