Genital HSV Shedding among Kenyan Women Initiating Antiretroviral Therapy.
OBJECTIVE
Genital ulcer disease (GUD) prevalence increases in the first month of antiretroviral treatment (ART), followed by a return to baseline prevalence by month 3. Since most GUD is caused by herpes simplex virus type 2 (HSV-2), we hypothesized that genital HSV detection would follow a similar pattern after treatment initiation.


METHODS
We conducted a prospective cohort study of 122 HSV-2 and HIV-1 co-infected women with advanced HIV disease who initiated ART and were followed closely with collection of genital swab specimens for the first three months of treatment.


RESULTS
At baseline, the HSV detection rate was 32%, without significant increase in genital HSV detection noted during the first month or the third month of ART. HIV-1 shedding declined during this period; no association was also noted between HSV and HIV-1 shedding during this period.


CONCLUSIONS
Because other studies have reported increased HSV detection in women initiating ART and we have previously reported an increase in GUD during early ART, it may be prudent to counsel HIV-1 infected women initiating ART that HSV shedding in the genital tract may continue after ART initiation.
Kenyatta National Hospital, Nairobi, Kenya.
Griffins O
GO
Manguro
Department of Epidemiology, University of Washington, Seattle, Washington, United States of America.
Linnet N
LN
Masese
Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya.
Ruth W
RW
Deya
Department of Laboratory Medicine, University of Washington, Seattle, Washington, United States of America.
Amalia
A
Magaret
Department of Epidemiology, University of Washington, Seattle, Washington, United States of America.|Department of Laboratory Medicine, University of Washington, Seattle, Washington, United States of America.|Department of Medicine, University of Washington, Seattle, Washington, United States of America.|Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America.
Anna
A
Wald
Department of Epidemiology, University of Washington, Seattle, Washington, United States of America.|Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya.|Department of Medicine, University of Washington, Seattle, Washington, United States of America.|Department of Global Health, University of Washington, Seattle, Washington, United States of America.
R Scott
RS
McClelland
Department of Epidemiology, University of Washington, Seattle, Washington, United States of America.|Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya.|Department of Medicine, University of Washington, Seattle, Washington, United States of America.|Department of Global Health, University of Washington, Seattle, Washington, United States of America.
Susan M
SM
Graham
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