Impact of Herpes Simplex Virus Type 2 on HIV-1 Acquisition and Progression in an HIV Vaccine Trial (the Step Study)
| Autor: | Yunda Huang, Karen E Mark, Judith N. Wasserheit, Rhoda Ashley Morrow, Martin Casapia, Lawrence Corey, Susan Buchbinder, Devan V. Mehrotra, Holly Janes, Jonathan D. Fuchs, Ruanne V. Barnabas |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Anti-HIV Agents Herpesvirus 2 Human viruses HIV Infections Biology Article Men who have sex with men Young Adult Risk Factors Internal medicine medicine Humans Pharmacology (medical) Homosexuality Male Young adult Risk factor AIDS Vaccines Transmission (medicine) Hazard ratio Vaccine trial Herpes Simplex Middle Aged Viral Load biology.organism_classification Infectious Diseases Lentivirus Immunology HIV-1 Viral load |
| Zdroj: | JAIDS Journal of Acquired Immune Deficiency Syndromes. 57:238-244 |
| ISSN: | 1525-4135 |
| Popis: | Introduction: Extensive observational data suggest that herpes simplex virus type 2 (HSV-2) infection may facilitate HIV acquisition, increase HIV viral load, and accelerate HIV progression and onward transmission. To explore these relationships, we examined the impact of preexisting HSV-2 infection in an international HIV vaccine trial. Methods: We analyzed the associations between prevalent HSV-2 infection and HIV-1 acquisition and progression among 1836 men who have sex with men. We used Cox proportional hazards regression models to estimate the association between HSV-2 infection and both HIV acquisition and antiretroviral therapy (ART) initiation, and linear regression to explore the effect of HSV-2 on pre-ART viral load. Results: HSV-2 infection increased risk of HIV-1 acquisition among all volunteers [adjusted hazard ratio 2.2; 95% confidence interval (CI): 1.4 to 3.5]. Adjusting for demographic variables, circumcision, Ad5 titer, and significant risk behaviors, the risk of HIV acquisition among HSV-2-infected placebo recipients was 3-fold higher than HSV-2 seronegatives (adjusted hazard ratio 3.3; 95% CI: 1.6 to 6.9). Past HSV-2 infection was associated with a 0.2 log 10 copies per milliliter higher adjusted mean set point viral load (95% CI: 0.3 lower to 0.6 higher). HSV-2 infection was not associated with time to ART initiation. Conclusions: Among men who have sex with men in an HIV-1 vaccine trial, preexisting HSV-2 infection was a major risk factor for HIV acquisition. Past HSV-2 did not significantly increase HIV viral load or early disease progression. HSV-2-seropositive persons will likely prove more difficult than HSV-2-seronegative persons to protect against HIV infection using vaccines or other prevention strategies. |
| Databáze: | OpenAIRE |
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