Effect of aciclovir on HIV-1 acquisition in herpes simplex virus 2 seropositive women and men who have sex with men: a randomised, double-blind, placebo-controlled trial

Abstract

SummaryBackground-Across many observational studies, herpes simplex virus type 2 (HSV-2) infection is associated with two-fold to three-fold increased risk for HIV-1 infection. We investigated whether HSV-2 suppression with aciclovir would reduce the risk of HIV-1 acquisition.

Australian sexually transmissible infection and HIV testing guidelines for asymptomatic men who have sex with men 2014: a review of the evidence

“…43 Although a transmission synergy between HSV and HIV is generally thought to exist, 116 interventions to suppress HSV-2 viral replication with aciclovir have not been shown to reduce the risk of HIV acquisition in two randomised controlled trials. 117,118 HSV western blot remains the gold standard for serological diagnosis of HSV. 119 Type-specific HSV-2 serology that uses glycoprotein G2 antigen are commercially available, although there are concerns regarding test performance in different populations with varying HSV-2 prevalence.…”

Prevalence and Determinants of Herpes Simplex Virus Type 2 (HSV-2)/Syphilis Co-Infection and HSV-2 Mono-Infection among Human Immunodeficiency Virus Positive Men Who Have Sex with Men: a Cross-Sectional Study in Northeast China

“…Herpes simplex virus type 2 (HSV-2) is one of the most common sexually transmitted pathogen and the most frequent cause of genital ulcers (3). HSV-2 and HIV have a synergistic relationship in that HSV-2 infection increases the susceptibility to and transmission of HIV, and HIV infection increases the susceptibility to HSV-2 infection and HSV-2 genital shedding (3,4). Syphilis can cause genital ulcers and increase the likelihood of shedding of the HIV.…”

CUA guideline on the care of the normal foreskin and neonatal circumcision in Canadian infants

“…In a HIV vaccine trial (Step study) conducted in MSM men, HSV-2 infection was an important risk factor for HIV acquisition amongst vaccine and placebo recipients (HR 2.2, 95% CI 1.4-3.5) [115]. It is likely that the correlation between these CUAJ -Guideline Dave et al Guideline: Foreskin care and neonatal circumcision two infections is due to high-risk sexual behavior making it unclear whether HSV-2 acquisition is an important direct cofactor for HIV infection [116][117][118].…”