Lolis Margarita S, González Lenis, Cohen Philip J, Schwartz Robert A
New Jersey Medical School, Newark, NJ 07103, USA.
Acta Dermatovenerol Croat. 2008;16(4):204-8.
Herpes simplex virus type 2 (HSV2) infection is a major source of morbidity in human immunodeficiency virus (HIV)-infected patients, since reactivations - whether symptomatic or asymptomatic - are associated with increased HIV viral load and viral shedding. Acyclovir, valacyclovir and famcyclovir are indicated for the treatment of HSV2 in HIV patients. This class of drugs has been shown to enhance survival in HIV-infected individuals. However, with the emergence of drug-resistant strains of HSV2, the rates of resistance among HIV patients are almost ten-fold those in immunocompetent individuals, comparing 0.6% to 6%. These HSV2 infections tend to be more severe and to recur. More ominously, disease progression of HIV is promoted by concurrent infection with HSV2. Intravenous foscarnet and cidofovir may be used for acyclovir-resistant HSV; however, resistance to these drugs has been documented. Newer therapies such as the toll-like receptor agonist imiquimod and immunomodulating dipeptides offer promise for the treatment of HSV2 in HIV-infected individuals.
2型单纯疱疹病毒（HSV2）感染是人类免疫缺陷病毒（HIV）感染患者发病的主要原因，因为病毒再激活——无论有无症状——都与HIV病毒载量增加和病毒脱落有关。阿昔洛韦、伐昔洛韦和泛昔洛韦被用于治疗HIV患者的HSV2感染。这类药物已被证明可提高HIV感染者的生存率。然而，随着HSV2耐药菌株的出现，HIV患者中的耐药率几乎是免疫功能正常个体的十倍，分别为0.6%和6%。这些HSV2感染往往更严重且会复发。更不祥的是，HSV2合并感染会促进HIV的疾病进展。静脉注射膦甲酸钠和西多福韦可用于治疗对阿昔洛韦耐药的HSV；然而，对这些药物的耐药情况已有记录。新型疗法如Toll样受体激动剂咪喹莫特和免疫调节二肽为治疗HIV感染个体的HSV2带来了希望。
