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Infect Dis Obstet Gynecol. 2008;2008:592532. doi: 10.1155/2008/592532.

Progressive hypertrophic genital herpes in an HIV-infected woman despite immune recovery on antiretroviral therapy.

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  • 1Department of Obstetrics and Gynecology, St. Michael's Hospital, Toronto, ON, Canada. yudinm@smh.toronto.on.ca


Most HIV-infected individuals are coinfected by Herpes simplex virus type 2 (HSV-2). HSV-2 reactivates more frequently in HIV-coinfected individuals with advanced immunosuppression, and may have very unusual clinical presentations, including hypertrophic genital lesions. We report the case of a progressive, hypertrophic HSV-2 lesion in an HIV-coinfected woman, despite near-complete immune restoration on antiretroviral therapy for up to three years. In this case, there was prompt response to topical imiquimod. The immunopathogenesis and clinical presentation of HSV-2 disease in HIV-coinfected individuals are reviewed, with a focus on potential mechanisms for persistent disease despite apparent immune reconstitution. HIV-infected individuals and their care providers should be aware that HSV-2 may cause atypical disease even in the context of near-comlpete immune reconstitution on HAART.

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