Cervicovaginal HIV-1 and herpes simplex virus type 2 shedding during genital ulcer disease episodes
Cervicovaginal HIV-1 and herpes simplex virus type 2 shedding during genital ulcer disease episodes
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DOI：
10.1097/qad.0b013e32825a69bd
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发表时间：
2007-07-31
期刊：
影响因子：
3.8
通讯作者：
Belec, Laurent
中科院分区：
文献类型：
--
作者：
LeGoff, Jerome;Weiss, Helen A.;Belec, Laurent
目的：探讨女性生殖器溃疡（GUD）患者单纯疱疹病毒2型（HSV-2） DNA与HIV-1 RNA的相关性。设计：来自加纳和中非共和国偶发性疱疹治疗的随机安慰剂对照试验的基线数据。方法：采用聚合酶链式反应（PCR）对患处拭子进行病因分析。采用Real-time PCR定量检测宫颈灌洗液（CVL）中HIV-1 RNA、HSV-2 DNA及血浆中HIV-1 RNA。生殖器感染被定义为病变或CVL中存在病毒。结果：入组的441名妇女中，79.0%为HSV-2血清阳性，46.6%为HIV-1血清阳性，50.0%为HSV-2溃疡。在180名合并感染HSV-2/HIV-1的女性中，宫颈阴道HIV-1 RNA在有HSV-2溃疡的女性（67.9%）或宫颈阴道仅有HSV-2 DNA的女性（72.3%）中检出的频率高于未感染HSV-2的女性（42.4%）（P=0.004）。感染生殖器HSV-2的妇女的宫颈-阴道hiv -1 rna中位载量较高(3.14 log(10) copies/mL vs 2.10 log(10) copies/mL)；P = 0.003)，较高的血浆HIV-1-RNA载量(中位数5.10 vs 4.65 log(10) copies/mL；P= 0.07)， CD4细胞计数中位数较低（198 vs 409细胞/mm(3)， P=0.03）。在调整血浆HIV-1 RNA和CD4细胞计数后，宫颈阴道HIV-1 RNA和HSV-2 DNA显著相关（P < 0.001），宫颈阴道HSV-2 DNA升高10倍与血浆HIV-1 RNA升高1.7倍相关（P=0.003）。结论：生殖器HSV-2感染与合并感染的生殖器溃疡妇女的宫颈阴道和血浆HIV-1 RNA增加有关，与免疫缺陷水平无关，突出了这两种病毒之间的密切相互作用以及HSV-2作为HIV-1性传播的辅助因素的作用。(c) 2007年Lippincott Williams & Wilkins。
Objective: To investigate correlates of herpes simplex virus type 2 (HSV-2) DNA and HIV-1 RNA among women with genital ulcer disease (GUD).Design: Baseline data from a randomized placebo-controlled trial of episodic herpes treatment in Ghana and the Central African Republic.Methods: GUD aetiology was determined by polymerase chain reaction (PCR) from a lesional swab. Real-time PCR was used to quantify HIV-1 RNA, and HSV-2 DNA in cervicovaginal lavages (CVL) and HIV-1 RNA in plasma. Genital infection was defined as the presence of virus in the lesion or CVL.Results: Of 441 women enrolled, 79.0% were HSV-2 seropositive, 46.6% were HIV-1 seropositive, and 50.0% had an HSV-2 ulcer. Among 180 HSV-2/HIV-1 co-infected women, cervicovaginal HIV-1 RNA was detected more frequently in women with HSV-2 ulcers (67.9%) or cervicovaginal HSV-2 DNA only (72.3%) compared with women without genital HSV-2 infection (42.4%) (P=0.004). Women with genital HSV-2 infection had higher median cervicovaginal HIV-1-RNA loads (3.14 log(10) copies/mL versus 2.10 log(10) copies/mL; P = 0.003), higher plasma HIV-1-RNA loads (median 5.10 versus4.65 log(10) copies/mL; P = 0.07), and lower median CD4 cell counts) (198 versus 409 cells/mm(3), P=0.03). Cervicovaginal HIV-1 RNA and HSV-2 DNA were significantly correlated after adjusting for plasma HIV-1 RNA and CD4 cell counts (P < 0.001) and a 10-fold increase in cervicovaginal HSV-2 DNA was associated with a 1.7-fold increase in plasma HIV-1 RNA (P=0.003).Conclusion: Genital HSV-2 infection is associated with increased cervicovaginal and plasma HIV-1 RNA among co-infected women with genital ulcers, independently of the level of immunodeficiency, highlighting the close interaction between these two viruses and the role of HSV-2 as a co-factor for the sexual transmission of HIV-1. (c) 2007 Lippincott Williams & Wilkins.