The association between genital ulcer disease and acquisition of HIV infection in homosexual men

W. E. Stamm, H. H. Handsfield, A. M. Rompalo, R. L. Ashley, P. L. Roberts and L. Corey
Department of Medicine, University of Washington School of Medicine, Seattle.

We analyzed the association of herpes simplex virus (HSV) infection and syphilis, the two most common causes of genital ulceration in homosexual men, with human immunodeficiency virus (HIV) infection in 200 men enrolled between 1983 and 1986 into a study evaluating the microbial causes of acute proctitis. Infection with HIV was independently associated with a history of syphilis, serologic evidence of syphilis, a history of HSV infection, and antibody to HSV-2. Antibody to HIV was not associated with a history of other genital infections or with antibody to Chlamydia trachomatis or HSV-1. Similar associations were observed in 111 asymptomatic homosexuals seen for HIV screening. Men who presented with primary HSV proctitis had a lower prevalence of HIV antibody than those with preexisting HSV-2 antibody (44% vs 68%); this suggests that HSV-2 infection antedated HIV infection. These data suggest that genital ulcerative diseases are an important risk factor for the acquisition of HIV infection in homosexual men; measures directed at control of these diseases may reduce the transmission of HIV in this population.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Improved Performance of Enzyme-Linked Immunosorbent Assays and the Effect of Human Immunodeficiency Virus Coinfection on the Serologic Detection of Herpes Simplex Virus Type 2 in Rakai, Uganda
Gamiel et al.
CVI 2008;15:888-890.
ABSTRACT | FULL TEXT  

Synergistic Copathogens -- HIV-1 and HSV-2
Corey
NEJM 2007;356:854-856.
FULL TEXT  

High Risk of Human Immunodeficiency Virus in Men Who Have Sex with Men with Herpes Simplex Virus Type 2 in the EXPLORE Study
Brown et al.
Am J Epidemiol 2006;164:733-741.
ABSTRACT | FULL TEXT  

Prevalence of infection with herpes simplex virus types 1 and 2 in Australia: a nationwide population based survey.
Cunningham et al.
Sex. Transm. Infect. 2006;82:164-168.
ABSTRACT | FULL TEXT  

Biological Basis for Syphilis
LaFond and Lukehart
Clin. Microbiol. Rev. 2006;19:29-49.
ABSTRACT | FULL TEXT  

The psychosocial impact of serological herpes simplex type 2 testing in an urban HIV clinic
Meyer et al.
Sex. Transm. Infect. 2005;81:309-315.
ABSTRACT | FULL TEXT  

Once-Daily Valacyclovir to Reduce the Risk of Transmission of Genital Herpes
Corey et al.
NEJM 2004;350:11-20.
ABSTRACT | FULL TEXT  

Latent Herpes Simplex Virus Infection of Sensory Neurons Alters Neuronal Gene Expression
Kramer et al.
J. Virol. 2003;77:9533-9541.
ABSTRACT | FULL TEXT  

Intranasal Immunization with CpG Oligodeoxynucleotides as an Adjuvant Dramatically Increases IgA and Protection Against Herpes Simplex Virus-2 in the Genital Tract
Gallichan et al.
J. Immunol. 2001;166:3451-3457.
ABSTRACT | FULL TEXT  

The Application of a Plasmid DNA Encoding IFN-{{alpha}}1 Postinfection Enhances Cumulative Survival of Herpes Simplex Virus Type 2 Vaginally Infected Mice
Harle et al.
J. Immunol. 2001;166:1803-1812.
ABSTRACT | FULL TEXT  

Strong Decline in Herpes Simplex Virus Antibodies Over Time among Young Homosexual Men Is Associated with Changing Sexual Behavior
Dukers et al.
Am J Epidemiol 2000;152:666-673.
ABSTRACT | FULL TEXT  

Relation Between Herpes Simplex Viruses and Human Immunodeficiency Virus Infections
Severson and Tyring
Arch Dermatol 1999;135:1393-1397.
ABSTRACT | FULL TEXT  

Prevalence of, Antibody Response to, and Immunity Induced by Haemophilus ducreyi Hemolysin
Dutro et al.
Infect. Immun. 1999;67:3317-3328.
ABSTRACT | FULL TEXT  

Syphilis: Review with Emphasis on Clinical, Epidemiologic, and Some Biologic Features
Singh and Romanowski
Clin. Microbiol. Rev. 1999;12:187-209.
ABSTRACT | FULL TEXT  

Genital Herpes: Review of the Epidemic and Potential Use of Type-Specific Serology
Ashley and Wald
Clin. Microbiol. Rev. 1999;12:1-8.
ABSTRACT | FULL TEXT  

Potential for the Transmission of HIV-1 despite Highly Active Antiretroviral Therapy
Haase and Schacker
NEJM 1998;339:1846-1848.
FULL TEXT  

Severe genital herpes infections in HIV-infected individuals with impaired herpes simplex virus-specific CD8+ cytotoxic T lymphocyte responses
Posavad et al.
Proc. Natl. Acad. Sci. USA 1997;94:10289-10294.
ABSTRACT | FULL TEXT  

Regaining a Valued Self: The Process of Adaptation to Living with Genital Herpes
Swanson and Chenitz
Qual Health Res 1993;3:270-297.
ABSTRACT