Increased genital shedding of herpes simplex virus type 2 in HIV-seropositive women

Ann Intern Med. 1995 Dec 1;123(11):845-7. doi: 10.7326/0003-4819-123-11-199512010-00006.


Objective: To compare the prevalence of genital herpes simplex virus type 2 (HSV-2) shedding in human immunodeficiency virus (HIV)-seropositive women and HIV-seronegative women.

Design: Cross-sectional study.

Setting: A major inner-city medical center.

Patients: 106 women who were HIV-seropositive and HSV-2-seropositive and 70 women who were HIV-seronegative and HSV-2-seropositive were enrolled from various primary care settings.

Measurements: Herpes simplex virus type 2 antibody determinations were done for all patients. Regardless of symptoms, vulvar and cervical HSV cultures were obtained from all HIV-seropositive women and from a randomly selected subgroup of HIV-seronegative women.

Results: The prevalence of HSV-2 shedding was nearly four times greater in HIV-seropositive than in HIV-seronegative women (13.2% compared with 3.6%; P = 0.04; odds ratio, 4.1 [95% CI, 1.0 to 27.4]) when the serum antibody for HSV-2 was present. Seventy-nine percent of viral shedding among HIV-seropositive women was asymptomatic. Overall viral shedding increased significantly as the CD4 cell count decreased.

Conclusions: Women with HIV infection, particularly those with low CD4 cell counts, shed HSV-2 from the vulva and cervix more commonly than women not infected with HIV. Most of this shedding is asymptomatic.

Publication types

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

MeSH terms

  • CD4 Lymphocyte Count
  • Cross-Sectional Studies
  • Female
  • HIV Seropositivity / complications*
  • HIV Seropositivity / immunology
  • Herpes Genitalis / complications
  • Herpes Genitalis / transmission
  • Herpes Genitalis / virology*
  • Herpesvirus 2, Human / physiology*
  • Humans
  • Risk Factors
  • Virus Shedding*