title: Clinical burden of herpes simplex virus disease in people with human immunodeficiency virus.
abstract: BACKGROUND
  Serologic studies indicate that herpes simplex virus (HSV)-1 and HSV-2 infections are highly prevalent among people infected with HIV. As an ulcerative genital disease, HSV may be important to HIV transmission and HIV-comorbidity. Routine clinical care of HSV in this population has not been described.
  
  
  METHODS
  Data were abstracted from medical records of HIV-infected individuals by the Adult/Adolescent Spectrum of HIV Disease Project. Clinician-documented HSV diagnosis and HSV treatment, defined as any prescription for acyclovir, valacyclovir, or famciclovir, were the outcomes of interest. We present descriptive statistics and trends in HSV diagnosis and treatment.
  
  
  RESULTS
  Between 1989 and 2004, 61,299 people were followed in this study. HSV was diagnosed in 20% of the population, and 32% of the population received HSV antiviral prescriptions. Prescriptions for episodic treatment were given to 28% of patients, and 11% received prescriptions for suppressive therapy. The average annual rate of HSV diagnosis declined by 31% during the course of the study.
  
  
  CONCLUSIONS
  Clinically recognized HSV infections were frequent despite declining rates of diagnosis. Providers should have a high index of suspicion for HSV and consider routine screening and suppressive therapy for patients at risk of clinical disease.
authors.affiliation: School of Nursing, University of Washington, Seattle, WA, USA. tkeating@u.washington.edu
authors.forename: Tamarind M
authors.initials: TM
authors.lastname: Keating
authors.forename: Ann E
authors.initials: AE
authors.lastname: Kurth
authors.forename: Anna
authors.initials: A
authors.lastname: Wald
authors.forename: Erin M
authors.initials: EM
authors.lastname: Kahle
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Barash
authors.forename: Susan E
authors.initials: SE
authors.lastname: Buskin
mesh_terms: D015075:2-Aminopurine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000212:Acyclovir / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage*; D015897:Comorbidity; D000077595:Famciclovir; D005260:Female; D006679:HIV Seropositivity / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission; D006561:Herpes Simplex / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission; D018259:Herpesvirus 1, Human; D018258:Herpesvirus 2, Human; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077483:Valacyclovir; D014633:Valine / Q000008:administration & dosage / Q000031:analogs & derivatives*
chemical_list: D000998:Antiviral Agents; D015075:2-Aminopurine; D014633:Valine; D000077483:Valacyclovir; D000077595:Famciclovir; D000212:Acyclovir