Schacker T, Zeh J, Hu H L, Hill E, Corey L
Department of Medicine, University of Minnesota, Minneapolis, MN 55455, USA.
J Infect Dis. 1998 Dec;178(6):1616-22. doi: 10.1086/314486.
Herpes simplex virus (HSV) infection is common in persons coinfected with human immunodeficiency virus (HIV). In a prospective study, daily viral cultures of the mouth, genitals, and rectum were collected from 68 HIV-positive and 13 HIV-negative men who have sex with men. Subjects completed a median of 57 days of follow-up. Anogenital HSV-2 cultures were positive on 405 (9.7%) of 4167 days for HIV-positive men and on 24 (3.1%) of 766 days for HIV-negative men. Most reactivations were perirectal and subclinical. Risk factors for increased HSV-2 shedding among HIV-positive men were low CD4 cell count (odds ratio, 2.5; 95% confidence interval, 1.2-5.4) and antibodies to both HSV-1 and HSV-2 versus HSV-2 only (odds ratio, 1.9; 95% confidence interval, 1.0-3.7). Three isolates obtained from 3 separate subjects were resistant to acyclovir. Thus, subclinical HSV-2 reactivation is an important opportunistic infection in persons with HIV infection. Further studies are necessaryto determine the impact of subclinical HSV-2 reactivation on the natural history of HIV infection.
单纯疱疹病毒（HSV）感染在合并感染人类免疫缺陷病毒（HIV）的人群中很常见。在一项前瞻性研究中，从68名HIV阳性和13名HIV阴性的男男性行为者中收集口腔、生殖器和直肠的每日病毒培养物。受试者的中位随访时间为57天。在4167天中，HIV阳性男性的肛门生殖器HSV - 2培养物有405天（9.7%）呈阳性，而HIV阴性男性在766天中有24天（3.1%）呈阳性。大多数再激活发生在直肠周围且为亚临床症状。HIV阳性男性中HSV - 2脱落增加的危险因素是CD4细胞计数低（比值比，2.5；95%置信区间，1.2 - 5.4）以及同时具有HSV - 1和HSV - 2抗体与仅具有HSV - 2抗体相比（比值比，1.9；95%置信区间，1.0 - 3.7）。从3名不同受试者中获得的3株分离株对阿昔洛韦耐药。因此，亚临床HSV - 2再激活是HIV感染者重要的机会性感染。有必要进一步研究以确定亚临床HSV - 2再激活对HIV感染自然史的影响。
