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 Conference
"HSV and HIV- A Troublesome Synergy?"
Dr. Dr. Robert Patrick O'Brien (biography)
English - 2004-06-28 - 36 minutes
(36 slides)

Summary :
In this presentation, Dr. O’Brien takes a look at the increasingly recognized problem presented by HSV/HIV co-infection. HSV infection is one of the most common sexually transmitted illnesses in the world. 20% to 25% of the North American population is infected. Men who have sex with men (MSM) have a higher rate of HSV infection (50% in non-HIV-infected persons) and this rate is increased even further in HIV-infected MSM. Moreover, an increasing amount of genital herpes is due to HSV-1 infection, especially among MSM.

Genital herpes is underdiagnosed, according to Dr. O’Brien, in part because the majority of cases are either asymptomatic or present with atypical symptoms.

Dr. O’Brien reveals how HSV infection acts as a cofactor for HIV transmission, acquisition and progression. HIV effects on the natural history of HSV infection are also discussed.

In this presentation, the relative benefits and draw-backs of different HSV diagnostic modalities are presented as well as the treatment options for HSV alone and HSV in the setting of HIV co-infection.

Dr. O’Brien concludes his talk with a discussion of the potential benefits of treating HSV infection in both HIV+ and HIV- individuals and the need for objective data to support these theoretical advantages.

Copyright © 2004 E-MedHosting.com Inc

Learning objectives :
After viewing this presentation, participants will be able to discuss:
- The magnitude of the Genital Herpes epidemic in the North America.
- The role of HSV in potentiating the transmission, acquisition, and progression of HIV.
- The role of HIV in promoting the spread of HSV and in altering its Natural History.
- The potential benefit to both HIV-infected and non-infected individuals of treating HSV infection and the evidence for these.

Bibliographic references :
Corey L, Handsfield HH.Genital herpes and public health: addressing a global problemJAMA. 2000 Feb 9;283(6):791-4.

Gottlieb SL, Douglas JM Jr, Schmid DS, Bolan G, Iatesta M, Malotte CK, Zenilman J, Foster M, Baron AE, Steiner JF, Peterman TA, Kamb ML; Project RESPECT Study Group.Seroprevalence and correlates of herpes simplex virus type 2 infection in five sexually transmitted-disease clinics.J Infect Dis. 2002 Nov 15;186(10):1381-9. Epub 2002 Oct 23.

Lafferty WE, Downey L, Celum C, Wald A.Herpes simplex virus type 1 as a cause of genital herpes: impact on surveillance and prevention.J Infect Dis. 2000 Apr;181(4):1454-7. Epub 2000 Apr 13.

Holmberg SD, Stewart JA, Gerber AR, Byers RH, Lee FK, O'Malley PM, Nahmias AJ.Prior herpes simplex virus type 2 infection as a risk factor for HIV infection.JAMA. 1988 Feb 19;259(7):1048-50.

Schacker T. The role of HSV in the transmission and progression of HIV. Herpes. 2001 Jul;8(2):46-9.

Schacker T, Ryncarz AJ, Goddard J, Diem K, Shaughnessy M, Corey L. Frequent recovery of HIV-1 from genital herpes simplex virus lesions in HIV-1-infected men. JAMA. 1998 Jul 1;280(1):61-6.

Augenbraun M, Feldman J, Chirgwin K, Zenilman J, Clarke L, DeHovitz J, Landesman S, Minkoff H.Increased genital shedding of herpes simplex virus type 2 in HIV-seropositive women.Ann Intern Med. 1995 Dec 1;123(11):845-7.

Wald A, Link K.Risk of human immunodeficiency virus infection in herpes simplex virus type 2-seropositive persons: a meta-analysis.J Infect Dis. 2002 Jan 1;185(1):45-52. Epub 2001 Dec 14.

Gray RH, Wawer MJ, Brookmeyer R, Sewankambo NK, Serwadda D, Wabwire-Mangen F, Lutalo T, Li X, vanCott T, Quinn TC; Rakai Project Team.Probability of HIV-1 transmission per coital act in monogamous, heterosexual, HIV-1-discordant couples in Rakai, Uganda.Lancet. 2001 Apr 14;357(9263):1149-53.

Wald A.New therapies and prevention strategies for genital herpes.Clin Infect Dis. 1999 Jan;28 Suppl 1:S4-13.

Wald A, Langenberg AG, Link K, Izu AE, Ashley R, Warren T, Tyring S, Douglas JM Jr, Corey L.Effect of condoms on reducing the transmission of herpes simplex virus type 2 from men to women.JAMA. 2001 Jun 27;285(24):3100-6.

Corey L, Wald A, Patel R, Sacks SL, Tyring SK, Warren T, Douglas JM Jr, Paavonen J, Morrow RA, Beutner KR, Stratchounsky LS, Mertz G, Keene ON, Watson HA, Tait D, Vargas-Cortes M; Valacyclovir HSV Transmission Study Group.Once-daily valacyclovir to reduce the risk of transmission of genital herpes.N Engl J Med. 2004 Jan 1;350(1):11-20.

Schacker T, Zeh J, Hu H, Shaughnessy M, Corey L.Changes in Plasma Human Immunodeficiency Virus Type 1 RNA Associated with Herpes Simplex Virus Reactivation and Suppression J Infect Dis. 2002 Dec 15;186(12):1718-25. Epub 2002 Nov 22.

DeJesus E, Wald A, Warren T, Schacker TW, Trottier S, Shahmanesh M, Hill JL, Brennan CA; Valacyclovir International HSV Study Group.Valacyclovir for the suppression of recurrent genital herpes in human immunodeficiency virus-infected subjects.J Infect Dis. 2003 Oct 1;188(7):1009-16. Epub 2003 Sep 10.


Additional references of interest

Posavad CM, Wald A, Kuntz S, Huang ML, Selke S, Krantz E, Corey L. Frequent reactivation of herpes simplex virus among HIV-1-infected patients treated with highly active antiretroviral therapy. J Infect Dis. 2004 Aug 15;190(4):693-6. Epub 2004 Jul 13.

Mostad SB, Kreiss JK, Ryncarz A, Chohan B, Mandaliya K, Ndinya-Achola J, Bwayo JJ, Corey L.Cervical shedding of herpes simplex virus and cytomegalovirus throughout the menstrual cycle in women infected with human immunodeficiency virus type 1.Am J Obstet Gynecol. 2000 Oct;183(4):948-55.

Wald A, Huang ML, Carrell D, Selke S, Corey L. Polymerase chain reaction for detection of herpes simplex virus (HSV) DNA on mucosal surfaces: comparison with HSV isolation in cell culture. J Infect Dis. 2003 Nov 1;188(9):1345-51. Epub 2003 Oct 31.

Wald A, Corey L.How does herpes simplex virus type 2 influence human immunodeficiency virus infection and pathogenesis?J Infect Dis. 2003 May 15;187(10):1509-12.

   


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