Clinical Reactivations of Herpes Simplex Virus Type 2 Infection and Human Immunodeficiency Virus Disease Progression Markers

PLoS One

Stephen J. Gange¹  Ruth Greenblatt²  Mardge Cohen³  Lorie Benning⁴  Bulbulgul Aumakhan⁴  Howard Minkoff⁴  Thomas C. Quinn⁵  Charlotte A. Gaydos⁵  Chris Beyrer⁶  Daniel J. Merenstein⁷  Marek Nowicki⁸  Kathryn Anastos⁹ 

[1]Albert Einstein College of Medicine, Bronx, New York, United States of America

[2]Cook County Medical Center, Chicago, Illinois, United States of America

[3]Georgetown University Medical Center, Washington, D. C., United States of America

[4]Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America

[5]Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America

[6]Laboratory of Immunoregulation, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America

[7]Maimonides Medical Center and SUNY Downstate, Brooklyn, New York, United States of America

[8]Schools of Pharmacy and Medicine, University of California San Francisco, San Francisco, California, United States of America

[9]University of Southern California, Los Angeles, California, United States of America

关键词: T cells;    HIV clinical manifestations;    HIV;    Herpes simplex virus-2;    Lesions;    HIV infections;    Women's health;    Highly-active antiretroviral therapy;   

DOI  :  10.1371/journal.pone.0009973

学科分类：医学（综合）

来源: Public Library of Science

【 摘 要 】

Background The natural history of HSV-2 infection and role of HSV-2 reactivations in HIV disease progression are unclear.Methods Clinical symptoms of active HSV-2 infection were used to classify 1,938 HIV/HSV-2 co-infected participants of the Women's Interagency HIV Study (WIHS) into groups of varying degree of HSV-2 clinical activity. Differences in plasma HIV RNA and CD4+ T cell counts between groups were explored longitudinally across three study visits and cross-sectionally at the last study visit.Results A dose dependent association between markers of HIV disease progression and degree of HSV-2 clinical activity was observed. In multivariate analyses after adjusting for baseline CD4+ T cell levels, active HSV-2 infection with frequent symptomatic reactivations was associated with 21% to 32% increase in the probability of detectable plasma HIV RNA (trend p = 0.004), an average of 0.27 to 0.29 log10 copies/ml higher plasma HIV RNA on a continuous scale (trend p<0.001) and 51 to 101 reduced CD4+ T cells/mm3 over time compared to asymptomatic HSV-2 infection (trend p<0.001).Conclusions HIV induced CD4+ T cell loss was associated with frequent symptomatic HSV-2 reactivations. However, effect of HSV-2 reactivations on HIV disease progression markers in this population was modest and appears to be dependent on the frequency and severity of reactivations. Further studies will be necessary to determine whether HSV-2 reactivations contribute to acceleration of HIV disease progression.

【 授权许可】

CC BY