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Transient Increase in Herpes Simplex Virus Type 2 (HSV-2)–Associated Genital Ulcers Following Initiation of Antiretroviral Therapy in HIV/HSV-2–Coinfected Individuals
- Publication Year :
- 2015
- Publisher :
- Oxford University Press, 2015.
-
Abstract
- BACKGROUND Immune reconstitution inflammatory syndrome (IRIS) in human immunodeficiency virus (HIV)-infected persons beginning antiretroviral therapy (ART) has been incompletely characterized for herpes simplex virus type 2 (HSV-2). METHODS We evaluated genital ulcer disease (GUD) and HSV-2-associated GUD at quarterly visits or when spontaneously reported at monthly visits in 3381 HIV/HSV-2-coinfected individuals in a placebo-controlled trial of suppressive acyclovir therapy to prevent HIV transmission, 349 of whom initiated ART during the study. Incidence was calculated for months before and after ART initiation, and incidence rate ratios (IRRs) were calculated. RESULTS GUD incidence increased from 15.0 episodes per 100 person-years before ART to 26.9 episodes per 100 person-years in the first full quarter after ART initiation (IRR, 1.83;P= .03), and the incidence of HSV-2-associated GUD increased from 8.1 to 19.0 episodes per 100 person-years (IRR, 2.20;P= .02). Subsequently, the incidence of GUD was similar to that before ART, although the numbers were small. Persons receiving suppressive acyclovir had fewer GUD episodes, but the IRR after beginning ART was similar in the acyclovir and placebo groups. CONCLUSIONS Initiation of ART in HIV/HSV-2-coinfected persons is associated with a transient increase in GUD and HSV-2 GUD. Acyclovir reduces the incidence of GUD but does not prevent an increase in GUD incidence during the first quarter following initiation of ART.
- Subjects :
- 0301 basic medicine
Adult
Male
medicine.medical_specialty
viruses
Herpesvirus 2, Human
Acyclovir
HIV Infections
urologic and male genital diseases
Placebo
medicine.disease_cause
03 medical and health sciences
Major Articles and Brief Reports
0302 clinical medicine
Immune reconstitution inflammatory syndrome
Immune Reconstitution Inflammatory Syndrome
Internal medicine
Antiretroviral Therapy, Highly Active
medicine
Immunology and Allergy
Humans
Sex organ
030212 general & internal medicine
Herpes Genitalis
Ulcer
business.industry
Coinfection
Incidence (epidemiology)
Incidence
virus diseases
Middle Aged
medicine.disease
Virology
female genital diseases and pregnancy complications
Genital ulcer
030104 developmental biology
Infectious Diseases
Herpes simplex virus
Female
medicine.symptom
business
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....4e9d5045bf5c93400ca13a676a048b73