Herpes simplex virus type 2 infection as a risk factor for human immunodeficiency virus acquisition in men who have sex with men

Renzi, C.; Douglas, J.M.; Foster, M.; Critchlow, C.W.; Ashley-Morrow, R.; Buchbinder, S.P.; Koblin, B.A.; McKirnan, D.J.; Mayer, K.H.; Celum, C.L.

Journal of Infectious Diseases 187(1): 19-25


ISSN/ISBN: 0022-1899
PMID: 12508142
DOI: 10.1086/345867
Accession: 010746100

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The association of human immunodeficiency virus (HIV) acquisition with herpes simplex virus type 2 (HSV-2) was assessed among men who have sex with men (MSM) in a nested case-control study of 116 case subjects who seroconverted to HIV during follow-up and 342 control subjects who remained HIV seronegative, frequency-matched by follow-up duration and report of HIV-infected sex partner and unprotected anal sex. The baseline HSV-2 seroprevalence was higher among case (46%) than control (34%) subjects (P = .03); the HSV-2 seroincidence was 7% versus 4% (P = .3). Only 15% of HSV-2-infected MSM reported herpes outbreaks in the past year. HIV acquisition was associated with prior HSV-2 infection (odds ratio (OR), 1.8; 95% confidence interval (CI), 1.1-2.9), reporting >12 sex partners (OR, 2.9; 95% CI, 1.4-6.3), and reporting fewer herpes outbreaks in the past year (OR, 0.3; 95% CI, 0.1-0.8). HSV-2 increases the risk of HIV acquisition, independent of recognized herpes lesions and behaviors reflecting potential HIV exposure. HSV-2 suppression with antiviral therapy should be evaluated as an HIV prevention strategy among MSM.