HSV for tumour lysis

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Effect of antiherpes therapy on HIV replication and transmission

Presented by C Celum, University of Washington, Seattle, USA.

Increasing evidence demonstrates a substantial link between the epidemics of sexually transmitted HIV-1 and herpes simplex virus type 2 (HSV-2) infection. In vitro and in vivo studies suggest that mucosal HIV-1 shedding is more frequent and in greater amounts during mucocutaneous HSV-2 replication, including subclinical mucosal reactivations. The majority of HIV-1 infected persons are co-infected with HSV-2, most of whom experience frequent subclinical and clinical HSV-2 reactivations. Subclinical HSV reactivation elevates serum HIV-1 RNA levels, and daily therapy with aciclovir appears to reduce plasma HIV-1 RNA. These data show that greater attention to the diagnosis and treatment of HSV-2 among HIV-1-infected persons is warranted, especially in those who continue to be sexually active, those not on antiretroviral therapy, or those not well suppressed by antiretrovirals. Proof-of-concept trials employing aciclovir, designed to prevent HIV acquisition among HIV-susceptible persons with HSV-2 infection, and HIV transmission in HIV-discordant couples, will address the hypothesis raised from the results of a large number of observational studies linking HSV-2 and HIV acquisition and transmission. These intervention trials will be reviewed and implications for the management of HSV-2 in HIV-infected persons discussed.

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Last Updated : 14/04/2004 10:43:40