Calculating the contribution of herpes simplex virus type 2 epidemics to increasing HIV incidence: treatment implications

Clin Infect Dis. 2004 Nov 1;39 Suppl 5:S240-7. doi: 10.1086/422361.


Herpes simplex virus type 2 (HSV-2) is the most prevalent sexually transmitted pathogen worldwide. There is considerable biological and epidemiological evidence that HSV-2 infection increases the risk of acquiring HIV infection and may also increase the risk of transmitting HIV. Here, we use a mathematical model to predict the effect of a high-prevalence HSV-2 epidemic on HIV incidence. Our results show that HSV-2 epidemics can more than double the peak HIV incidence; that the biological heterogeneity in susceptibility and transmission induced by an HSV-2 epidemic causes HIV incidence to rise, fall, and then rise again; and that HSV-2 epidemics concentrate HIV epidemics, creating a "core group" of HIV transmitters. Our modeling results imply that findings from HSV-2 intervention trials aimed at reduction of HIV incidence will be variable and that positive findings will be obtained only from trials in communities in which HIV incidence is steeply rising.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Disease Susceptibility
  • Female
  • HIV Infections / complications
  • HIV Infections / epidemiology
  • HIV Infections / transmission*
  • Herpes Genitalis / complications*
  • Herpes Genitalis / epidemiology
  • Humans
  • Incidence
  • Male
  • Models, Theoretical
  • Monte Carlo Method
  • Prevalence
  • Risk Factors
  • Uncertainty
  • Virus Shedding