Impact of Herpes Simplex Virus Type 2 on HIV-1 Acquisition and Progression in an HIV Vaccine Trial (the Step Study)

• DOI: 10.1097/qai.0b013e31821acb5
• Publication Date: 2011-06-15T12:54:10Z
• Authors: Ruanne V Barnabas; Judith N Wasserheit; Yunda Huang; Holly Janes; Rhoda Morrow; Jonathan Fuchs; Karen E Mark; Martin Casapia; Devan V Mehrotra; Susan P Buchbinder; Lawrence Corey
• Keywords: AIDS Vaccines; Adult; Male; Adolescent; Anti-HIV Agents; Herpesvirus 2, Human; HIV Infections; Herpes Simplex; Middle Aged; Viral Load; 3. Good health; Young Adult; 03 medical and health sciences; 0302 clinical medicine; Risk Factors; HIV-1; Humans; Homosexuality, Male

Extensive observational data suggest that herpes simplex virus type 2 (HSV-2) infection may facilitate HIV acquisition, increase viral load, and accelerate progression onward transmission. To explore these relationships, we examined the impact of preexisting HSV-2 in an international vaccine trial.We analyzed associations between prevalent HIV-1 acquisition among 1836 men who have sex with men. We used Cox proportional hazards regression models to estimate association both antiretroviral therapy (ART) initiation, linear effect on pre-ART load.HSV-2 increased risk all volunteers [adjusted hazard ratio 2.2; 95% confidence interval (CI): 1.4 3.5]. Adjusting for demographic variables, circumcision, Ad5 titer, significant behaviors, HSV-2-infected placebo recipients was 3-fold higher than seronegatives (adjusted 3.3; CI: 1.6 6.9). Past associated a 0.2 log10 copies per milliliter adjusted mean set point load (95% 0.3 lower 0.6 higher). not time ART initiation.Among trial, major factor acquisition. did significantly or early disease progression. HSV-2-seropositive persons will likely prove more difficult HSV-2-seronegative protect against using vaccines other prevention strategies.