Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Office of the Director, 1600 Clifton Road, NE, E-07, Atlanta, GA 30333, United States.
Drug Alcohol Depend. 2013 Aug 1;131(3):182-97. doi: 10.1016/j.drugalcdep.2013.03.013. Epub 2013 May 4.
Herpes simplex virus type 2 (HSV-2) affects HIV acquisition, transmission, and disease progression. Effective medications for genital herpes and for HIV/AIDS exist. Parenteral transmission of HIV among persons who inject drugs is decreasing. Reducing sexual transmission of HIV and HSV-2 among persons who use drugs (PWUD; i.e., heroin, cocaine, "speedball", crack, methamphetamine through injection or non-injection) necessitates relevant services.
We reviewed HSV-2 sero-epidemiology and HSV-2/HIV associations in U.S.-based studies with PWUD and the general literature on HSV-2 prevention and treatment published between 1995 and 2012. We used the 6-factor Kass framework to assess relevant HSV-2 public health strategies and services in terms of their goals and effectiveness; identification of, and minimization of burdens and concerns; fair implementation; and fair balancing of benefits, burdens, and concerns.
Eleven studies provided HSV-2 serologic test results. High HSV-2 sero-prevalence (range across studies 38-75%) and higher sero-prevalence in HIV-infected PWUD (97-100% in females; 61-74% in males) were reported. Public health strategies for HSV-2 prevention and control in PWUD can include screening or testing; knowledge of HSV-2 status and partner disclosure; education, counseling, and psychosocial risk-reduction interventions; treatment for genital herpes; and HIV antiretroviral medications for HSV-2/HIV co-infected PWUD.
HSV-2 sero-prevalence is high among PWUD, necessitating research on development and implementation of science-based public health interventions for HSV-2 infection and HSV-2/HIV co-infections, including research on effectiveness and cost-effectiveness of such interventions, to inform development and implementation of services for PWUD.
单纯疱疹病毒 2 型（HSV-2）会影响 HIV 的感染、传播和疾病进展。目前已有治疗生殖器疱疹和 HIV/AIDS 的有效药物。注射吸毒者中 HIV 的经注射途径传播正在减少。减少吸毒者（如注射或非注射海洛因、可卡因、“冰毒”、“快球”、冰毒）中 HIV 和 HSV-2 的性传播需要相关的服务。
我们回顾了美国基于吸毒者的 HSV-2 血清流行病学和 HSV-2/HIV 相关性研究以及 1995 年至 2012 年发表的关于 HSV-2 预防和治疗的一般文献。我们使用 Kass 的 6 因素框架，根据其目标和有效性，评估了 HSV-2 的相关公共卫生策略和服务；确定和最小化负担和关注点；公平实施；以及公平平衡利益、负担和关注点。
11 项研究提供了 HSV-2 血清学检测结果。高 HSV-2 血清流行率（各研究中范围为 38-75%）和 HIV 感染的吸毒者中更高的血清流行率（女性为 97-100%；男性为 61-74%）被报道。针对吸毒者的 HSV-2 预防和控制的公共卫生策略可包括筛查或检测；了解 HSV-2 状况和伴侣披露；教育、咨询和心理社会风险降低干预；生殖器疱疹的治疗；以及针对 HSV-2/HIV 合并感染的吸毒者的 HIV 抗逆转录病毒药物。
吸毒者的 HSV-2 血清流行率很高，这需要对 HSV-2 感染和 HSV-2/HIV 合并感染的基于科学的公共卫生干预措施的开发和实施进行研究，包括对这些干预措施的有效性和成本效益进行研究，以指导为吸毒者提供服务的开发和实施。
