Vaccine and Infectious Disease Division

HIV’s influence on herpes shedding

It has long been known that there are complex interactions between HIV and herpes simplex virus 2 (HSV-2) infections.  HSV-2 infection increases the likelihood of both HIV acquisition and transmission, for reasons that remain partly unclear.  Recently, researchers have found that HSV-2 recurrences, most of which are symptom-less, in otherwise healthy patients occur much more often and are cleared much more quickly than was previously appreciated.  To understand whether herpes recurrences in HIV infected people follow similar patterns, former VIDD staff physician Dr. Karen Mark (currently Chief, HIV Surveillance, Research, and Evaluation Branch, California Department of Public Health Office of AIDS), along with VIDD affiliate investigator Dr. Anna Wald, joint assistant member Dr. Amalia Magaret, and co-director Dr. Larry Corey, tested oral and genital samples from 20 HIV and HSV-2 positive people for herpes simplex virus.

 The researchers asked the study participants to collect swabs themselves four times a day for 60 days.  They then used PCR to test for the presence of HSV-1 or HSV-2 in the swabs.  They found that, as in HIV negative people, HSV reactivation episodes are short, frequent, and often without symptoms in HIV positive people.  The majority of HSV reactivation episodes lasted less than 12 hours.  They also found that people with higher viral loads of HIV shed greater amounts of HSV, meaning these people may be more likely to transmit the herpes virus.  The frequency of herpes reactivation in HIV positive persons, and the concomitant trafficking and activation of immune cells to the genital area, may contribute to the higher rate of HIV transmission from HSV infected persons.

Mark KE, Wald A, Magaret AS, Selke S, Kuntz S, Huang ML, Corey L.  Rapidly Cleared Episodes of Oral and Anogenital Herpes Simplex Virus Shedding in HIV-Infected Adults.  J Acquir Immune Defic Syndr. 2010 Aug 15;54(5):482-8.