Association between cervical shedding of herpes simplex virus and HIV-1
McClelland, R.Scott.; Wang, C.C.; Overbaugh, J.; Richardson, B.A.; Corey, L.; Ashley, R.L.; Mandaliya, K.; Ndinya-Achola, J.; Bwayo, J.J.; Kreiss, J.K.
Aids 16(18): 2425-2430
2002
ISSN/ISBN: 0269-9370 PMID: 12461416 DOI: 10.1097/00002030-200212060-00007Document Number: 244550
Objective: To investigate the association between the cervical shedding of herpes simplex virus (HSV) and HIV-1. Design: A cross-sectional study on 200 women seropositive for both HSV-2 and HIV-1 was conducted in a family planning clinic at the Coast Provincial General Hospital, Mombasa, Kenya. Main outcome measures: Quantities of HSV DNA (types 1 and 2) and HIV-1 RNA as well as the presence or absence of HIV-1 proviral DNA in cervical secretions were determined and compared. Results: There was a significant correlation between the quantities of HSV DNA and HIV-1 RNA in the cervical secretions of HSV-shedding women (Pearson's r=0.24, P=0.05). A 10-fold increase in the quantity of cervical HSV DNA was associated with 1.35-fold higher cervical HIV-1-RNA levels (95% Cl 1.00-1.81; P=0.05), and with 1.36-fold greater odds of detection of HIV-1 proviral DNA (95% Cl 1.05-1.75; P=0.02). Conclusion: Higher levels of cervical HSV were associated with higher levels of expressed HIV-1 and with the more frequent detection of HIV-1-infected cells in cervical secretions. Prospective studies are needed to explore further the association between non-ulcerative cervical HSV reactivation and HIV-1 shedding. Such a relationship may have important implications for interventions designed to slow the spread of HIV-1.