Herpes Simplex Virus Type 2 Acquisition Among HIV-1-Infected Adults Treated With Tenofovir Disoproxyl Fumarate as Part of Combination Antiretroviral Therapy: Results From the ACTG A5175 PEARLS Study

J Infect Dis. 2017 Mar 15;215(6):907-910. doi: 10.1093/infdis/jix029.


Objective: Tenofovir disoproxyl fumarate (TDF) disoproxyl fumarate (TDF) has in vitro activity against herpes simplex virus type 2 (HSV-2) and reduced HSV-2 acquisition as preexposure prophylaxis. Whether TDF-containing antiretroviral therapy (ART) reduces HSV-2 acquisition is unknown.

Design: Secondary analysis of AIDS Clinical Trials Group A5175, a randomized, open-label study of 3 ART regimens among 1571 participants.

Methods: HSV-2 serostatus was assessed at baseline, at study exit, and before a change in ART regimen.

Results: Of 365 HSV-2-seronegative persons, 68 acquired HSV-2, with 24 receiving TDF-containing ART and 44 receiving ART without TDF (HSV-2 seroconversion incidence, 6.42 and 6.63 cases/100 person-years, respectively; hazard ratio, 0.89; 95% confidence interval, .55-1.44).

Conclusions: HSV-2 acquisition was not reduced in HIV-infected, HSV-2-uninfected persons during TDF-containing ART.

Keywords: Africa; HIV-1; HSV-2; antiretroviral therapy; prevention; tenofovir.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Antiviral Agents / therapeutic use*
  • Female
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • HIV-1 / drug effects
  • Herpes Simplex / prevention & control*
  • Herpesvirus 2, Human / drug effects*
  • Humans
  • International Cooperation
  • Male
  • Medication Adherence
  • Middle Aged
  • Pre-Exposure Prophylaxis*
  • Proportional Hazards Models
  • Seroconversion
  • Tenofovir / therapeutic use*
  • Young Adult


  • Antiviral Agents
  • Tenofovir