Ameli Niloufar, Bacchetti Peter, Morrow Rhoda Ashley, Hessol Nancy A, Wilkin Timothy, Young Mary, Cohen Mardge, Minkoff Howard, Gange Stephen J, Greenblatt Ruth M
Department of Medicine, Division of Infectious Diseases, University of California-San Francisco School of Medicine, San Francisco, CA 94143, USA.
AIDS. 2006 Apr 24;20(7):1051-8. doi: 10.1097/01.aids.0000222078.75867.77.
To determine the prevalence of infection with herpes simplex virus types 1 (HSV-1) and 2 (HSV-2) among women with and at high risk for HIV infection, and to evaluate the effect of HAART on the recurrence of genital lesions.
We evaluated the epidemiology and clinical manifestations associated with HSV-1 and HSV-2 among 1796 HIV-infected and 476 HIV-uninfected women enrolled in a multisite cohort study. Serum antibodies to HSV-1 and HSV-2 at baseline and self-reported history of genital herpes, reports of recent genital sores and presence of genital ulcers on examination, and use of HAART regimen at each study visit were analyzed.
Reactivity to HSV-1 only and HSV-2 only was detected in 18% and 20% of HIV-infected, and in 28% and 18% of HIV-uninfected participants respectively; 58% of HIV-infected women and 45% of HIV-uninfected women were seropositive for both HSV types. Reactivity to HSV-2 was associated with increasing age, more male sexual partners, earlier sexual debut, African-American race, Latina ethnicity, less education and lower income. HIV-uninfected women reported significantly fewer genital sores than HIV-infected women who had used HAART for at least 1 year and had optimal CD4 cell gain and viral suppression (adjusted odds ratio (OR), 0.19; 95% confidence interval (CI), 0.13-0.28).
Use of HAART and subsequent immune recovery does not completely eliminate the effect of HIV infection on genital lesions among women with concurrent HSV-2 infection.
确定感染人类免疫缺陷病毒（HIV）的女性及HIV感染高危女性中1型单纯疱疹病毒（HSV-1）和2型单纯疱疹病毒（HSV-2）的感染率，并评估高效抗逆转录病毒治疗（HAART）对生殖器病变复发的影响。
我们在一项多中心队列研究中，对1796名HIV感染女性和476名未感染HIV的女性进行了评估，分析与HSV-1和HSV-2相关的流行病学及临床表现。分析了基线时HSV-1和HSV-2的血清抗体以及自我报告的生殖器疱疹病史、近期生殖器溃疡报告、检查时生殖器溃疡的存在情况，以及每次研究访视时HAART方案的使用情况。
分别在18%的HIV感染参与者和28%的未感染HIV参与者中检测到仅对HSV-1有反应，在20%的HIV感染参与者和18%的未感染HIV参与者中检测到仅对HSV-2有反应；58%的HIV感染女性和45%的未感染HIV女性两种HSV类型血清学均呈阳性。对HSV-2的反应性与年龄增加、男性性伴侣增多、初次性行为较早、非裔美国人种族、拉丁裔族裔、教育程度较低和收入较低有关。未感染HIV的女性报告的生殖器溃疡明显少于使用HAART至少1年且CD4细胞获得最佳增加和病毒得到抑制的HIV感染女性（校正比值比（OR）为0.19；95%置信区间（CI）为0.13 - 0.28）。
使用HAART及随后的免疫恢复并不能完全消除HIV感染对合并HSV-2感染女性生殖器病变的影响。
