title: Herpes simplex virus type 2 infection as a risk factor for human immunodeficiency virus acquisition in men who have sex with men.
abstract: The association of human immunodeficiency virus (HIV) acquisition with herpes simplex virus type 2 (HSV-2) was assessed among men who have sex with men (MSM) in a nested case-control study of 116 case subjects who seroconverted to HIV during follow-up and 342 control subjects who remained HIV seronegative, frequency-matched by follow-up duration and report of HIV-infected sex partner and unprotected anal sex. The baseline HSV-2 seroprevalence was higher among case (46%) than control (34%) subjects (P=.03); the HSV-2 seroincidence was 7% versus 4% (P=.3). Only 15% of HSV-2-infected MSM reported herpes outbreaks in the past year. HIV acquisition was associated with prior HSV-2 infection (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.1-2.9), reporting >12 sex partners (OR, 2.9; 95% CI, 1.4-6.3), and reporting fewer herpes outbreaks in the past year (OR, 0.3; 95% CI, 0.1-0.8). HSV-2 increases the risk of HIV acquisition, independent of recognized herpes lesions and behaviors reflecting potential HIV exposure. HSV-2 suppression with antiviral therapy should be evaluated as an HIV prevention strategy among MSM.
authors.affiliation: Department of Medicine, University of Washington, Seattle, USA.
authors.forename: Cristina
authors.initials: C
authors.lastname: Renzi
authors.forename: John M
authors.initials: JM
authors.lastname: Douglas
authors.forename: Mark
authors.initials: M
authors.lastname: Foster
authors.forename: Cathy W
authors.initials: CW
authors.lastname: Critchlow
authors.forename: Rhoda
authors.initials: R
authors.lastname: Ashley-Morrow
authors.forename: Susan P
authors.initials: SP
authors.lastname: Buchbinder
authors.forename: Beryl A
authors.initials: BA
authors.lastname: Koblin
authors.forename: David J
authors.initials: DJ
authors.lastname: McKirnan
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Mayer
authors.forename: Connie L
authors.initials: CL
authors.lastname: Celum
mesh_terms: D016022:Case-Control Studies; D015658:HIV Infections / Q000209:etiology* / Q000517:prevention & control; D006558:Herpes Genitalis / Q000150:complications* / Q000628:therapy; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011446:Prospective Studies; D012307:Risk Factors; D012725:Sexual Behavior