Frequent recovery of HIV-1 from genital herpes simplex virus lesions in HIV-1-infected men

JAMA. 1998 Jul 1;280(1):61-6. doi: 10.1001/jama.280.1.61.


Context: Genital ulcer disease has been epidemiologically linked as a risk factor in the transmission of the human immunodeficiency virus 1 (HIV-1). While herpes simplex virus 2 (HSV-2) is the most common cause of genital ulcers, no study has systematically evaluated the frequency or titer of HIV-1 virus in HSV-2 lesions.

Objective: To compare lesional HIV-1 RNA levels during and after genital HSV-2 reactivation and to evaluate the frequency, titer, and duration of HIV-1 RNA shedding in lesions due to HSV-2.

Design: Convenience sample.

Setting: Sexually transmitted disease research clinic at the University of Washington, Seattle.

Patients: Twelve HIV-infected men with a history of symptomatic HSV-2 infection who underwent daily sampling of genital lesions for HIV-1 RNA by polymerase chain reaction assay and HSV-2 by culture.

Main outcome measure: Detection of lesional HIV RNA and HSV-2.

Results: HIV-1 RNA was detected from lesional swabs in 25 of 26 consecutively studied HSV-2 episodes and on 67% of days in which genital lesions were noted. The HIV-1 RNA titers in lesional swabs exceeded 10000 copies/mL of swab sample in 75% of samples (range, 2.2-3.2 x 10(5) copies/mL of swab sample). HIV-1 RNA in genital lesion swabs was seen in persons with high and low titers of plasma HIV-1 RNA and was not associated with plasma HIV-1 RNA levels.

Conclusions: HIV-1 virions can consistently be detected in genital ulcers caused by HSV-2, which suggests that genital herpes infection likely increases the efficiency of the sexual transmission of HIV-1.

Publication types

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

MeSH terms

  • Adult
  • HIV Infections / complications*
  • HIV Infections / transmission*
  • HIV-1 / genetics
  • HIV-1 / isolation & purification*
  • Herpes Genitalis / complications*
  • Herpes Genitalis / virology
  • Herpesvirus 2, Human / isolation & purification
  • Homosexuality, Male
  • Humans
  • Male
  • Middle Aged
  • Polymerase Chain Reaction
  • RNA, Viral / analysis
  • Risk Factors
  • Virus Shedding


  • RNA, Viral