title: Quantitative and qualitative correlates of cervicovaginal herpes simplex virus type 2 shedding among HIV-infected women in the Women's Interagency HIV Study.
abstract: We identified demographic, clinical and biological determinants of herpes simplex virus type 2 (HSV-2) shedding among HIV-infected participants in the Women's HIV Interagency Study (WIHS). Cervicovaginal lavage (CVL) specimens from 369 HIV-infected HSV seropositive women were tested with TaqMan polymerase chain reaction (PRC) for detection HSV-2 DNA. Seven percent of women tested positive for HSV-2 DNA in CVL. Significant correlates of the presence of HSV-2 DNA in CVL were being younger, African American or Hispanic race/ethnicity and injecting drugs in the past six months (P < 0.05). A borderline significant trend for reduced viral shedding with higher CD4+ T cell counts was observed (P = 0.08). All women who were never observed with any genital lesions and had consistently negative self-reported history of genital sores throughout the follow-up (n = 29, 8%) were negative for CVL HSV-2 DNA. HSV-2 DNA quantity was significantly associated with having frequent subsequent lesion recurrences (Spearman rho = 0.48, P = 0.016; adjusted prevalence ratio [APR] = 2.5, P = 0.012). Increasing the age of the host was inversely correlated with decreased viral shedding over time. However, a subset of older women continued to shed significant amounts of virus despite passage of time. This study provides genital HSV-2 DNA titre as a quantitative and symptom- and sign-based measures as qualitative predictors of HSV-2 shedding from the lower genital tract among HIV-infected women.
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. baumakha@jhsph.edu
authors.forename: B
authors.initials: B
authors.lastname: Aumakhan
authors.forename: S J
authors.initials: SJ
authors.lastname: Gange
authors.forename: C
authors.initials: C
authors.lastname: Beyrer
authors.forename: C A
authors.initials: CA
authors.lastname: Gaydos
authors.forename: H
authors.initials: H
authors.lastname: Minkoff
authors.forename: D J
authors.initials: DJ
authors.lastname: Merenstein
authors.forename: M H
authors.initials: MH
authors.lastname: Cohen
authors.forename: K
authors.initials: K
authors.lastname: Anastos
authors.forename: R
authors.initials: R
authors.lastname: Greenblatt
authors.forename: M J
authors.initials: MJ
authors.lastname: Nowicki
authors.forename: T C
authors.initials: TC
authors.lastname: Quinn
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D004279:DNA, Viral / Q000097:blood; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006558:Herpes Genitalis / Q000175:diagnosis* / Q000473:pathology / Q000821:virology*; D018258:Herpesvirus 2, Human / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D016133:Polymerase Chain Reaction; D012307:Risk Factors; D044364:Vaginal Douching; D017201:Virus Shedding
chemical_list: D000914:Antibodies, Viral; D004279:DNA, Viral