Article

Herpes simplex virus type 2 and syphilis infections with HIV: an evolving synergy in transmission and prevention.

Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, USA.
Current opinion in HIV and AIDS (Impact Factor: 4.39). 08/2009; 4(4):294-9. DOI: 10.1097/COH.0b013e32832c1881
Source: PubMed

ABSTRACT Herpes simplex virus type 2 (HSV-2) and syphilis are associated with HIV infection. The purpose of this review is to summarize the advances in the relationship of HSV-2 and syphilis with HIV, highlighting intervention trials to prevent HIV acquisition and transmission.
HIV acquisition has often been linked to genital ulcers due to HSV-2 and syphilis. The latest pathophysiological studies have continued to elucidate the relationship between HSV-2, syphilis and HIV, establishing that both syphilitic and HSV-2-infected tissue have increased numbers of chemokine receptor 5-expressing T cells, and several models have further emphasized the viral synergy between HSV-2 and HIV. In clinical trials, HSV suppressive therapy decreased HIV RNA levels that might affect transmission, but two trials have failed to prevent HIV acquisition. Male circumcision, however, prevents both HIV and HSV-2 acquisition.
Genital ulcers from HSV-2 and syphilis are associated with HIV acquisition. The exact role for these HIV cofactors is still unknown and exemplified by the failure of HSV suppressive therapy to decrease HIV acquisition. Male circumcision, however, reduces HSV-2 acquisition. With several HSV suppressive trials to prevent HIV transmission and disease progression currently ongoing, the future promises to provide more critical information for the control of HIV infection.

0 Followers
 · 
94 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Syphilis is a health problem of increasing incidence in recent years that may have severe complications if it is not diagnosed and treated at an early stage. There are many diagnostic tests available for syphilis, but there is no gold standard and diagnosis usually relies upon a combination of tests. In this multicenter study we evaluate the treponemal Elecsys® Syphilis assay for use in the diagnosis of syphilis in routine samples i.e. when syphilis is suspected, or during antenatal or blood donation screening. The sensitivity and specificity of the Elecsys® Syphilis assay was compared head to head with other treponemal assays used in routine clinical practice and was assessed in potentially cross-reactive samples from patients with Epstein-Barr virus, HIV and Lyme disease. In a total of 8,063 syphilis-negative samples collected from routine diagnostic requests and blood donations the Elecsys® Syphilis assay had a specificity of 99.88%. In 928 samples previously identified as syphilis-positive the sensitivity was 99.57-100% (the result is presented as a range depending on whether four initially indeterminate samples are included in the assessment). The specificity of the Elecsys® Syphilis assay in patients with other infections was 100%; no false positive samples were identified.
    Clinical and vaccine Immunology: CVI 10/2014; 22(1). DOI:10.1128/CVI.00505-14 · 2.37 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The incidence of syphilis in the United States is increasing; it is estimated that more than 55,000 new infections will occur in 2014. Treatment regimens are controversial, especially in specific populations, and assessing treatment response based on serology remains a challenge.
    JAMA The Journal of the American Medical Association 11/2014; 312(18):1905-17. DOI:10.1001/jama.2014.13259 · 30.39 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Intravaginal delivery offers an effective option for localized, targeted, and potent microbicide delivery. However, an understanding of the physiological factors that impact intravaginal delivery must be considered to develop the next generation of microbicides. In this review, a comprehensive discussion of the opportunities and challenges of intravaginal delivery are highlighted, in the context of the intravaginal environment and currently utilized dosage forms. After a subsequent discussion of the stages of microbicide development, the intravaginal delivery of proteins and oligonucleotides is addressed, with specific application to HSV and HIV. Future directions may include the integration of more targeted delivery modalities to virus and host cells, in addition to the use of biological agents to affect specific genes and proteins involved in infection. More versatile and multipurpose solutions are envisioned that integrate new biologicals and materials into potentially synergistic combinations to achieve these goals.
    Cellular and Molecular Life Sciences CMLS 10/2014; 72(3). DOI:10.1007/s00018-014-1756-3 · 5.86 Impact Factor

Preview

Download
0 Downloads
Available from