TY - JOUR
T1 - Clinical reactivations of herpes simplex virus type 2 infection and human immunodeficiency virus disease progression markers
AU - Aumakhan, Bulbulgul
AU - Gaydos, Charlotte A.
AU - Quinn, Thomas C.
AU - Beyrer, Chris
AU - Benning, Lorie
AU - Minkoff, Howard
AU - Merenstein, Daniel J.
AU - Cohen, Mardge
AU - Greenblatt, Ruth
AU - Nowicki, Marek
AU - Anastos, Kathryn
AU - Gange, Stephen J.
PY - 2010
Y1 - 2010
N2 - 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.
AB - 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.
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U2 - 10.1371/journal.pone.0009973
DO - 10.1371/journal.pone.0009973
M3 - Article
C2 - 20376310
AN - SCOPUS:77956332703
SN - 1932-6203
VL - 5
JO - PloS one
JF - PloS one
IS - 4
M1 - e9973
ER -