Genital HSV Infection Worsens Right After ART Initiation

The interaction between HIV and herpes simplex virus (HSV) follows the pattern of many other coinfections: Each condition tends to exacerbate the other. Still, although it is generally accepted that untreated HIV infection worsens the frequency and severity of genital HSV outbreaks, little research has addressed the patterns of genital HSV infection right after antiretroviral therapy (ART) is begun.

As part of a large, placebo-controlled, prospective trial of twice-daily acyclovir for retarding HIV progression among HIV/HSV-coinfected patients in Rakai, Uganda, researchers evaluated the clinical and virologic sequelae of genital herpes in patients who began ART. During 24 months of follow-up, CD4 counts dropping to <250 cells/mm³ or WHO stag…