Herpes simplex virus and HIV-1: deciphering viral synergy.
Recent proof-of-concept randomised controlled trials have shown a causal relation between herpes simplex virus (HSV) type 2 infection and HIV-1 replication in co-infected individuals. We explore the mechanisms that may operate to enhance reciprocal viral replication. Direct interactions could involve HIV-1-related immune deficiency, disruption of mucosal barrier by HSV infection/reactivation, HSV-induced mucosal cell recruitment, transactivation of HIV-1 replication by HSV proteins, and immune modulation by HSV decoys. Indirect interactions might coexist through disturbances of the vaginal flora during HSV shedding and systemic immune activation. In co-infected individuals, suppressive HSV treatment reduces HIV-1 genital and systemic excretion. This finding is a likely result of efficacious prevention of HSV2 reactivations, and perhaps of other herpesviruses. Strategies to control HSV2 and other herpesviruses deserve urgent attention and should become part of the HIV-1 prevention and care package.
Van de Perre
Philippe
P
EA 4205 Transmission, Pathogenèse et Prévention de l'Infection par le VIH, Université Montpellier 1 and Laboratories of Bacteriology and Virology, CHU Montpellier, Montpellier, France. p-van_de_perre@chu-montpellier.fr
Segondy
Michel
M
Foulongne
Vincent
V
Ouedraogo
Abdoulaye
A
Konate
Issouf
I
Huraux
Jean-Marie
JM
Mayaud
Philippe
P
Nagot
Nicolas
N
D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000821:virology; D015497:HIV-1 / Q000502:physiology*; D006561:Herpes Simplex / Q000150:complications* / Q000276:immunology / Q000821:virology; D006801:Humans; D008297:Male; D016032:Randomized Controlled Trials as Topic; D018139:Simplexvirus / Q000502:physiology*; D014775:Virus Activation; D014779:Virus Replication