title: No impact of oral tenofovir disoproxil fumarate on herpes simplex virus shedding in HIV-infected adults.
abstract: OBJECTIVE
  to determine the impact of oral tenofovir as part of combination antiretroviral therapy on asymptomatic herpes simplex virus (HSV) shedding.
  
  
  METHODS
  observational study of a cohort of HSV, HIV-1 co-infected adults.
  
  
  METHODS
  HSV infection was diagnosed using type-specific serology (HerpeSelect ELISA, Focus Technologies). Asymptomatic HSV, HIV-1 co-infected individuals achieving HIV viral load below 50 copies/ml on antiretroviral therapy self-collected oral, genital and anal swabs daily for 28 days. Refrigerated specimens were dropped off weekly for HSV-1 and HSV-2 testing by polymerase chain reaction (PCR). Shedding rate was calculated as the proportion of days on which HSV PCR was positive.
  
  
  RESULTS
  : Forty co-infected patients were enrolled, of whom 30 were HSV-2 seropositive. Tenofovir was part of the antiretroviral regimen in 22 of 40 (55%) participants overall and 17 of 30 (57%) of HSV-2 infected participants. The median (interquartile range) HSV-2 shedding rate among HSV-2 seropositive participants was low, at 7.1% (0, 14.3) of specimen collection days, and did not differ between tenofovir users and nonusers (P = 0.36). There was no difference in the number of HSV-2 shedders in the tenofovir and nontenofovir groups (59 vs. 46%; P = 0.49). Rates of shedding for HSV-1 alone (P = 0.59), and for either HSV-1 or HSV-2 (P = 0.38), were also similar between tenofovir users and nonusers.
  
  
  CONCLUSIONS
  although topical tenofovir 1% gel was associated with a significant decrease in HSV-2 acquisition among high-risk women in the recent CAPRISA 004 trial, in these preliminary data we did not observe an impact of oral tenofovir on HSV-2 or HSV-1 shedding rates among HIV, HSV co-infected asymptomatic adults.
authors.affiliation: University Health Network Division of Infectious Diseases, Canada bUniversity of Toronto, Ontario, Canada. darrell.tan@gmail.com
authors.forename: Darrell Hs
authors.initials: DH
authors.lastname: Tan
authors.forename: Rupert
authors.initials: R
authors.lastname: Kaul
authors.forename: Janet M
authors.initials: JM
authors.lastname: Raboud
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Walmsley
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000188:drug therapy / Q000821:virology*; D000225:Adenine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D000328:Adult; D002170:Canada; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000821:virology*; D015497:HIV-1; D006561:Herpes Simplex / Q000188:drug therapy / Q000209:etiology / Q000821:virology*; D018259:Herpesvirus 1, Human / Q000187:drug effects; D018258:Herpesvirus 2, Human / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000008:administration & dosage* / Q000009:adverse effects; D000068698:Tenofovir; D017201:Virus Shedding
chemical_list: D063065:Organophosphonates; D000068698:Tenofovir; D000225:Adenine