Does having herpes (HSV-2) increase your chances of being infected with HIV?
MRC
Yes! It is most definitely a risk factor that has serious public health
implications, is the finding of a Policy Brief released by the HIV Prevention
Research Unit of the Medical Research Council (MRC).
Herpes simplex virus type II (HSV-2) is the most common cause of genital
ulcer disease worldwide. By damaging the epithelial barrier and causing
inflammation, it may increase the risk of HIV-1 transmission.
"It was therefore important for us to further investigate the
relationship between HIV-1 and HSV-2 and the associated risk factors. We
measured baseline HIV-1 and HSV-2 among a group of female sex workers
participating in a vaginal microbicide clinical trial and, investigated the risk
factors associated with HIV-1 and HSV-2 . We studied the effect that infection
with HSV-2 had on the eventual incidence of HIV-1 among women who started the
trial being HIV-negative. In other words, the relationship between the incidence
of HSV-2 and HIV," says Dr Gita Ramjee, Principal Investigator of this
study.
According to the Policy Brief, 416 women were screened for HIV of whom only
198 were HIV-negative. These HIV-negative women were monitored monthly over a
period of 3 years. Of the women who seroconverted (became HIV-positive), all but
6 became HSV-2 positive before they became HIV-1 positive. The data suggest that
immediately after infection with HSV-2, the risk of contracting HIV-1 increases
significantly
A seemingly paradoxical finding is that women who were already HSV-2 positive
at the start of the study had a significantly lower incidence of HIV, while
women who got HSV-2 during the trial had a higher incidence of HIV.
A possible explanation of this finding, says the Policy Brief, is that women
previously exposed to HSV-2 may be protected from super-infection with the
circulant HSV-2. There is strong evidence that HSV-2 reinfection does not occur.
This reduced their risk of acquiring new HSV-2 infection and thus of getting
ulcers and sores which are a risk factor for HIV-1. This paradoxical finding
requires further investigation. The study also suggests an urgent need to
develop HSV-2 vaccines.
Recommendations
There is an urgent need to recognise HSV-2 infection among populations at
risk, especially the young, and to provide treatment and counselling on condom
use. Results from a recent study have shown that condoms can effectively reduce
HSV-2 transmission.
Identification of new HSV-2 infection in pregnancy may indirectly impact on
mother-to-child transmission of HIV-1
While rapid tests for HIV-1 and syphilis are available, no such tests are
available for HSV-2 screening. Priority should be given to the development of
rapid HSV-2-specific tests.
There is a need to integrate HSV-2 and HIV-1 prevention efforts in all countries
at risk of increasing HIV-1 infections.
Intensive efforts and funding are currently invested in the development of an
HIV-1 vaccine. This study has shown that equally, there is an urgent need to
develop an HSV-2 vaccine in order to curb the spread of both HIV-1 and HSV-2.
For more information please contact Dr Gita Ramjee on (031) 203 4771 or Ms Merle
May on (021) 938-241. Alternatively for a copy of the policy brief contact Ms
Nadine Hendricks on (021) 938-0346 or e-mail nadine.hendricks@mrc.ac.za
or go to http://www.mrc.ac.za/policybriefs/policybriefs.htm
|
