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Herpes and HIV infection—has the time come to act?

Darren B. Russell

Cairns Sexual Health Centre, PO Box 902, Cairns, QLD 4870, Australia. Email:

Sexual Health 3(2) 67-71
Submitted: 5 January 2004  Accepted: 16 January 2006   Published: 26 May 2006


It has been known for some years that the ulcerative and inflammatory STIs lead to an increased risk of HIV transmission. In particular, there is a two- to four-fold increased risk of HIV-1 acquisition associated with prevalent herpes simplex virus type 2. The challenges are discussed herein.


[1]  Annan K . UNAIDS and World Health Organization Fact Sheet: Sub-Saharan Africa. UNAIDS Epidemic Update 2005. [verified May 2006].

[2]  National Centre in HIV Epidemiology and Clinical Research. 2005 Annual Surveillance Report. p. 5.

[3]  UNAIDS. [verified May 2006].

[4]  Fenton AF Imrie J 2005 Increasing rates of sexually transmitted diseases in homosexual men in Western Europe and the United States: why? Infect Dis Clin North Am 19 311 31 doi:10.1016/j.idc.2005.04.004 Pubmed Abstract

[5]  Swearingen SG Klausner JD 2005 Sildenafil use, sexual risk behaviour, and risk for sexually transmitted diseases, including HIV infection. Am J Med 118 6 571 77 doi:10.1016/j.amjmed.2005.01.042 Pubmed Abstract

[6]  O’Farrell N 2001 Targeted interventions required against genital ulcers in African countries worst affected by HIV infection. Bull World Health Organ 79 569 77 Pubmed Abstract

[7]  Wasserheit JN 1992 Epidemiological synergy. Interrelationships between human immunodeficiency virus infection and other sexually transmitted diseases. Sex Transm Dis 19 61 7 Pubmed Abstract

[8]  Moss GB Overbaugh J Welch M Reilly M Bwayo J Plummer FA et al 1995 Human immunodeficiency virus DNA in urethral secretions in men: association with gonococcal urethritis and CD4 cell depletion. J Infect Dis 172 6 1469 74 Pubmed Abstract

[9]  Atkins MC Carlin EM Emery VC Griffiths PD Boag F 1996 Fluctuations of HIV load in semen of HIV positive patients with newly acquired sexually transmitted diseases. BMJ 313 7053 341 2 Pubmed Abstract

[10]  Dickerson MC Johnston J Delea TE White A Andrews E 1996 The causal role for genital ulcer disease as a risk factor for transmission of human immunodeficiency virus. An application of the Bradford Hill criteria. Sex Transm Dis 23 5 429 40 Pubmed Abstract

[11]  Uter W Pfahlberg A 2001 The application of methods to quantify attributable risk in medical practice. Stat Methods Med Res 10 3 231 7 doi:10.1191/096228001680195175 Pubmed Abstract

[12]  Ghys PD Diallo MO Ettiegne-Traore V Satten GA Anoma CK Maurice C et al 2001 Effect of interventions to control sexually transmitted disease on the incidence of HIV infection in female sex workers. AIDS 15 11 1421 31 doi:10.1097/00002030-200107270-00012 Pubmed Abstract

[13]  Grosskurth H Gray R Hayes R Mabey D Wawer M 2000 Control of sexually transmitted diseases for HIV-1 prevention: understanding the implications of the Mwanza and Rakai trials. Lancet 355 9219 1981 7 doi:10.1016/S0140-6736(00)02336-9 Pubmed Abstract

[14]  Corey L Wald A Celum CL Quinn TC 2004 The effects of herpes simplex virus-2 on HIV-1 acquisition and transmission: a review of two overlapping epidemics. J Acquir Immune Defic Syndr 35 5 435 45 Pubmed Abstract

[15]  Website for ‘’. [verified April 2006].

[16]  Fleming DT McQuillan GM Johnson RE Nahmias AJ Aral SO Lee FK et al 1997 Herpes simplex virus type 2 in the United States, 1976 to 1994. N Engl J Med 337 1105 11 doi:10.1056/NEJM199710163371601 Pubmed Abstract

[17]  Chen CY Ballard RC Beck-Sague CM Dangor Y Radebe F Schmid S et al 2000 Human immunodeficiency virus infection and genital ulcer disease in South Africa: the herpetic connection. Sex Transm Dis 27 21 9 Pubmed Abstract

[18]  Paz-Bailey G Rahman M Chen C Ballard R Moffat HJ Kenyon T et al 2005 Changes in the etiology of sexually transmitted diseases in Botswana between 1993 and 2002: implications for the clinical management of genital ulcer disease. Clin Infect Dis 41 9 1304 12 doi:10.1086/496979 Pubmed Abstract

[19]  Russell DB Tabrizi SN Russell JM Garland SM 2001 Seroprevalence of herpes simplex virus types 1 and 2 in HIV-infected and uninfected homosexual men in a primary care setting. J Clin Virol 22 305 13 doi:10.1016/S1386-6532(01)00203-7 Pubmed Abstract

[20]  Auvert B Ballard R Campbell C Carael M Carton M Fehler G et al 2001 HIV infection among youth in a South African mining town is associated with herpes simplex virus-2 seropositivity and sexual behaviour. AIDS 15 7 885 98 doi:10.1097/00002030-200105040-00009 Pubmed Abstract

[21]  Wald A Link K 2002 Risk of human immunodeficiency virus infection in herpes simplex virus type 2-seropositive persons: a meta-analysis. J Infect Dis 185 45 52 doi:10.1086/338231 Pubmed Abstract

[22]  Renzi C Douglas JM Foster M Critchlow CW Ashley-Morrow R Buchbinder SP et al 2003 Herpes simplex type 2 infection as a risk factor for human immunodeficiency acquisition in men who have sex with men. J Infect Dis 187 19 25 doi:10.1086/345867 Pubmed Abstract

[23]  Freeman EE Glynn JR 2004 Factors affecting HIV concordancy in married couples in four African cities. AIDS 18 1715 21 doi:10.1097/01.aids.0000139075.13906.2f Pubmed Abstract

[24]  Auvert B Buvé A Ferry B Caraël M Morrison L Lagarde E et al 2001 Ecological and individual factor analysis of risk factors for HIV infection in four urban populations in sub-Saharan Africa with different levels of HIV infection. AIDS 15 Suppl 4 S15 30 doi:10.1097/00002030-200108004-00003 Pubmed Abstract

[25]  Blower S Ma L 2004 Calculating the contribution of Herpes simplex virus type 2 epidemics to increasing HIV incidence: treatment implications. Clin Infect Dis 39 Suppl 5 S240 7 doi:10.1086/422361 Pubmed Abstract suppl 5

[26]  Corey L Tyring S Patel R Sacks SL Tyring SK Warren T et al 2004 Once daily valaciclovir to reduce the risk of transmission of genital herpes. N Engl J Med 350 11 20 doi:10.1056/NEJMoa035144 Pubmed Abstract

[27]  World Health Organization. Microbicides. [verified April 2006].

[28]  Dhawan D Mayer KH 2006 Microbicides to prevent HIV transmission: overcoming obstacles to chemical barrier protection. J Infect Dis 193 1 36 44 doi:10.1086/499163 Pubmed Abstract

[29]  Diamond C Richardson JL Milam J Stoyanoff S McCutchan JA Kemper C et al 2005 Use of and adherence to antiretroviral therapy is associated with decreased sexual risk behavior in HIV clinic patients. J Acquir Immune Defic Syndr 39 2 211 8 Pubmed Abstract

[30]  Bateganya M Colfax G Shafer LA Kityo C Mugyenyi P Serwadda D et al 2005 Antiretroviral therapy and sexual behavior: a comparative study between antiretroviral- naive and -experienced patients at an urban HIV/AIDS care and research center in Kampala, Uganda. AIDS Patient Care STDS 19 11 760 8 doi:10.1089/apc.2005.19.760 Pubmed Abstract

[31]  Bunnell R Ekwaru JP Solberg P Wamai N Bikaako-Kajura W Were W et al 2006 Changes in sexual behavior and risk of HIV transmission after antiretroviral therapy and prevention interventions in rural Uganda. AIDS 20 1 85 92 doi:10.1097/01.aids.0000196566.40702.28 Pubmed Abstract

[32]  Smith RJ Bodine EN Wilson DP Blower SM 2005 Evaluating the potential impact of vaginal microbicides to reduce the risk of acquiring HIV in female sex workers. AIDS 19 4 413 21 doi:10.1097/01.aids.0000161771.44276.92 Pubmed Abstract

[33]  Auvert B , Puren A , Taljaard D , Lagarde E , Sitta R , Tambekou J , et al Impact of male circumcision on the female-to-male transmission of HIV. Program and abstracts of the 3rd IAS Conference on HIV Pathogenesis and Treatment, 24–27 July 2005, Rio de Janeiro, Brazil. Abstract TuOa0402.

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