Lancet Infect Dis. 2008 Aug;8(8):490-7.

Herpes simplex virus and HIV-1: deciphering viral synergy.

Van de Perre P, Segondy M, Foulongne V, Ouedraogo A, Konate I, Huraux JM, Mayaud P, Nagot N.

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EA 4205 Transmission, Pathogenèse et Prévention de l'Infection par le VIH, Université Montpellier 1 and Laboratories of Bacteriology and Virology, CHU Montpellier, Montpellier, France. p-van_de_perre@chu-montpellier.fr

Abstract

Recent proof-of-concept randomised controlled trials have shown a causal relation between herpes simplex virus (HSV) type 2 infection and HIV-1 replication in co-infected individuals. We explore the mechanisms that may operate to enhance reciprocal viral replication. Direct interactions could involve HIV-1-related immune deficiency, disruption of mucosal barrier by HSV infection/reactivation, HSV-induced mucosal cell recruitment, transactivation of HIV-1 replication by HSV proteins, and immune modulation by HSV decoys. Indirect interactions might coexist through disturbances of the vaginal flora during HSV shedding and systemic immune activation. In co-infected individuals, suppressive HSV treatment reduces HIV-1 genital and systemic excretion. This finding is a likely result of efficacious prevention of HSV2 reactivations, and perhaps of other herpesviruses. Strategies to control HSV2 and other herpesviruses deserve urgent attention and should become part of the HIV-1 prevention and care package.

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