Association between cervical shedding of herpes simplex virus and HIV-1

International AIDS Research and Training Program, Department of Medicine, University of Washington, Box 359909, 325 9th Avenue, Seattle, WA 98104, USA.
AIDS (Impact Factor: 5.55). 01/2003; 16(18):2425-30. DOI: 10.1097/00002030-200212060-00007
Source: PubMed


To investigate the association between the cervical shedding of herpes simplex virus (HSV) and HIV-1.
A cross-sectional study on 200 women seropositive for both HSV-2 and HIV-1 was conducted in a family planning clinic at the Coast Provincial General Hospital, Mombasa, Kenya.
Quantities of HSV DNA (types 1 and 2) and HIV-1 RNA as well as the presence or absence of HIV-1 proviral DNA in cervical secretions were determined and compared.
There was a significant correlation between the quantities of HSV DNA and HIV-1 RNA in the cervical secretions of HSV-shedding women (Pearson's r = 0.24, P = 0.05). A 10-fold increase in the quantity of cervical HSV DNA was associated with 1.35-fold higher cervical HIV-1-RNA levels (95% CI 1.00-1.81; P = 0.05), and with 1.36-fold greater odds of detection of HIV-1 proviral DNA (95% CI 1.05-1.75; P = 0.02).
Higher levels of cervical HSV were associated with higher levels of expressed HIV-1 and with the more frequent detection of HIV-1-infected cells in cervical secretions. Prospective studies are needed to explore further the association between non-ulcerative cervical HSV reactivation and HIV-1 shedding. Such a relationship may have important implications for interventions designed to slow the spread of HIV-1.

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    • "The group of women with evidence of HSV-2 genital shedding had higher genital HIV-1 RNA loads than control women, in agreement with other reports [8] [10]. Compartmentalization was observed between genital HIV-1 RNA, genital HIV-1 DNA, and plasma HIV-1 RNA, independently of HSV-2 genital reactivation , suggesting that HSV-2 genital replication did not significantly affect the tissue adaptation of HIV-1 variants. "
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    ABSTRACT: Clinical and subclinical genital HSV-2 reactivations have been associated with increases of HIV-1 genital shedding. Whether herpes simplex virus type 2 (HSV-2) shedding contributes to the selection of specific genital HIV-1 variants remains unknown. We evaluated the genetic diversity of genital and blood HIV-1 RNA and DNA in 14 HIV-1-/HSV-2- co-infected women, including 7 with HSV-2 genital reactivation and 7 without as controls. HIV-1 DNA and HIV-1 RNA env V1-V3 sequences in paired blood and genital samples were compared. The Herpes selection pressure on HIV was estimated with the number of synonymous (dS) and non-synonymous substitutions (dN) and the dS/dN ratio within HIV quasi-species. HIV-1 RNA levels in cervicovaginal secretions were higher in women with HSV-2 replication than in controls (p=0.02). Plasma HIV-1 RNA and genital HIV-1 RNA and DNA were genetically compartmentalized. No difference in dS, dN and dS/dN ratios was observed between the study groups for both genital HIV-1 RNA and plasma HIV-1 RNA. In contrast, dS and dN in genital HIV-1 DNA were significantly higher in patients with genital herpes reactivation (p<0.01 and p<0.05, respectively). The mean of dS/dN ratio in genital HIV-1 DNA was slightly higher in patients with herpetic genital replication, indicating a trend for a purifying selection (p=0.056). HSV-2 increased genetic diversity of genital HIV-1 DNA. These observations confirm molecular interactions between HSV-2 and HIV-1 at the genital tract level. Copyright © 2015. Published by Elsevier Ltd.
    Clinical Microbiology and Infection 05/2015; DOI:10.1016/j.cmi.2015.05.014 · 5.77 Impact Factor
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    • "Moreover, other infections might have additional mechanisms in which they could affect the transmission of HIV. For example, the genital reactivations of HSV-2 generate local immune activations in genital ulcerations that might increment HIV shedding in the genital tracks [72]. This STI infection not only affects the risk of transmission but also increases the risk of acquisition in HIV-negative individuals, a characteristic that considerably affects the mode in which HSV-2 influences the pattern of HIV transmission at the population level [36,59]. "
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    Theoretical Biology and Medical Modelling 03/2012; 9(1):9. DOI:10.1186/1742-4682-9-9 · 0.95 Impact Factor
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    • "There is currently a great effort focused on the development of microbicides to prevent sexually transmitted diseases (STDs). Epidemiological studies consistently demonstrated that recurrent infection by herpes simplex virus (HSV) increases the risk of HIV-1 acquisition and enhances HIV-1 replication[25,26]. PRO 2000, a synthetic naphthalene sulfonic polymer, interacts with viral glycoproteins gp120 of HIV and glycoprotein B of HSV-2 and has been tested as microbicide to prevent viral infection. "
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