Table 2.
Association between HSV-2 and HIV-1 viral load.
| a) HSV-2 infection and HIV-1plasma viral load
| ||||||||
|---|---|---|---|---|---|---|---|---|
| Study | Location | Period | Study design | Endpoint/follow-up | Population | Study Size | Mean difference (95% CI) | Viral load assay |
| Barbour7 | Sao Paulo, Brazil | no details | Cohort | Quarterly visits, median follow-up 381 days | HSV-2/HIV-1 coinfected adults | 186 | 0.10 (−0.27, 0.47) | no details |
| HIV-1 infected adults with acute HSV-2 infection | 47 | 0.10 (−0.19, 0.39) | no details | |||||
| Cachay8 | San Diego, USA | 1996-2005 | Cross-sectional 1 | NA | HSV-2 seropositive men with incident HIV-1 infection | 85 | −0.17 (−0.73, 0.44) | RT-PCR |
| HSV-2 seropositive men with early HIV-1 infection | 209 | −0.12 (−0.45, 0.20) | RT-PCR | |||||
| Cachay9 | San Diego, USA | 1996-2005 | Cohort | Median follow-up 779 days | HIV-1 infected men with acute HSV-2 infection | 9 | 0.08 (−0.30, 0.46) | RT-PCR |
| Chu10 | Bangkok, Thailand | 2000–1 | Cross-sectional 2 | NA | HIV-1/HSV-2 coinfected men | 69 | 0.10 (−0.39, 0.59) | NASBA |
| HIV-1/HSV-2 coinfected women | 71 | 0.50 (0.03, 0.97) | NASBA | |||||
| Duffus11 | 2 sites, Uganda | 1997–9 | Cross-sectional | NA | HIV-1/HSV-2 coinfected individuals | 339 | 0.30 (0.07, 0.53) | no details |
| Gray12 | Rakai, Uganda | 1994–8 | Cross-sectional | NA | HIV-1/HSV-2 coinfected individuals | 345 | −0.09 (−0.28, 0.10) | RT-PCR |
| Mole13 | Palo Alto, USA | 1991–4 | Cohort | Single endpoint, 30–45 days | HIV infected males, with acute or reactive HSV-2 infection | 8 | 0.75 (0.30, 1.19) | bDNA |
| Serwadda14 | Rakai, Uganda | 1994–8 | Nested case-control | NA | Acute HIV-1 infected individuals, from a CRT of STI control | 219 | 0.55 (0.16, 0.94) | RT-PCR |
| b) HSV-2 treatment and HIV-1 plasma viral load
| |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Study | Location | Period | Study Design | Population | Therapy | Endpoint/follow-up | Study Size | Mean difference (95% CI) | VL assay |
| Suppressive therapy trials | |||||||||
| Baeten15 | Lima, Peru | 2005 | RCT | HIV-1/HSV-2 seropositive women | Suppressive (valacyclovir 500 mg twice daily for 8 weeks) | Weekly visits, 18 weeks (cross-over) | 20 | −0.26 (−0.33, −0.19) | RT-PCR |
| Celum16 | 14 sites in 7 countries in Africa | 2004–7 | RCT | Heterosexual HIV discordant couples | Suppressive (acyclovir 400 mg twice daily for 24 months) | Quarterly visits, 24 months | 3302 | −0.25 (−0.29, −0.22) | RT-PCR |
| Delany17 | Johannesburg, South Africa | 2005–6 | RCT | HIV-1/HSV-2 seropositive women | Suppressive (acyclovir 400 mg twice daily for 3 months) | Monthly visits, 3 months | 288 | −0.27 (−0.41, −0.13) | RT-PCR |
| Dunne18 | Chiang Rai, Thailand | no details | RCT | HIV-1/HSV-2 coinfected women | Suppressive (acyclovir 800 mg twice daily for 1 month) | Monthly visits, 3 months (cross-over) | 128 | −0.43 (−0.56, −0.29) | RT-PCR |
| Nagot19 | Burkino Faso | 2004–5 | RCT | HIV-1/HSV-2 coinfected women, | Suppressive (valacyclovir twice daily for 3 months) | Thrice weekly visits, 3 months | 136 | −0.53 (−0.72, −0.35) | RT-PCR |
| Schacker20 | Seattle, USA | 1994–6 | Cohort | Facility-recruited HIV/HSV-2 coinfected individuals | Suppressive (acyclovir 800 mg thrice daily for 8 weeks) | Weekly visits, 8 weeks | 12 | −0.28 (−0.54, −0.02) | bDNA |
| Tanton21 | Tanzania | 2004, 2006 | RCT | HIV-1/HSV-2 coinfected women attending mobile clinic | Suppressive (acyclovir 400 mg twice daily until censoring) | 6, 12 and 24 month visits, 24 months | 419 | 0.02 (−0.09, 0.13) | RT-PCR |
| Zuckerman22 | Lima, Peru | 2003–4 | RCT | HIV-1/HSV-2 coinfected MSM | Suppressive (valacyclovir 500 mg twice daily for 8 weeks) | Weekly visits, 18 weeks (cross-over) | 20 | −0.33 (−0.42, −0.23) | RT-PCR |
| Episodic therapy trials | |||||||||
| Mayaud23 | 3 sites in Ghana/CAR | 2003–7 | RCT | HIV-1 infected women with HSV-2 ulcers | Episodic (acyclovir 400 mg thrice daily for 5 days) | Single endpoint, 28 days | 93 | 0.09 (−0.10, 0.30) | RT-PCR |
| Mole13 | Palo Alto, USA | 1991–4 | Cohort | HIV infected males, with HSV-2 ulcers | Episodic (acyclovir 200 mg 5 times a day for 10 days) | Single endpoint, 30–45 days | 8 | −0.48 (−0.77, −0.20) | bDNA |
| Paz-Bailey24 | Gauteng, South Africa | 2005–6 | RCT | HIV-infected males with HSV ulcers | Episodic (acyclovir 400 mg thrice daily for 5 days) | Single endpoint, 28 days | 295 | −0.12 (−0.23, −0.01) | RT-PCR |
| Phiri25 | Lilongwe, Malawi | 2004–6 | RCT | HIV-1 infected individuals with HSV-2 ulcers | Episodic (acyclovir 800 mg twice daily for 5 days) | Single endpoint, 28 days | 244 | 0.09 (−0.08, 0.26) | RT-PCR |
| c) HSV-2 treatment and HIV-1 genital viral load
| |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Study | Location | Period | Population | Therapy | Endpoint/Follow-up | Specimen | Study Size | Mean difference (95% CI) | VL assay |
| Suppressive therapy trials | |||||||||
| Baeten15 | Lima, Peru | 2005 | HIV-1/HSV-2 seropositive women | Suppressive (valacyclovir 500 mg twice daily for 8 weeks) | Weekly visits, 18 weeks (cross-over) | Self-collected genital swab | 20 | −0.67 (−1.08, −0.26) | RT-PCR |
| Endocervical swab specimen | 20 | −0.35 (−0.46, −0.25) | RT-PCR | ||||||
| Delany17 | Johannesburg, South Africa | 2005–6 | HIV-1/HSV-2 seropositive women | Suppressive (acyclovir 400 mg twice daily for 3 months) | Monthly visits, 3 months | Cervicovaginal lavage | 288 | −0.13 (−0.28, 0.03) | RT-PCR |
| Dunne18 | Chiang Rai, Thailand | no details | HIV-1/HSV-2 coinfected women | Suppressive (acyclovir 800 mg twice daily for 1 month) | Monthly visits, 3 months (cross-over) | Cervicovaginal lavage | 128 | −0.32 (−0.48, −0.19) | RT-PCR |
| Nagot26 | Burkino Faso | 2004–5 | HIV-1/HSV-2 coinfected women | Suppressive (valacyclovir twice daily for 3 months) | Thrice weekly visits, 3 months | Cervicovaginal lavage | 136 | −0.29 (−0.44, −0.15) | RT-PCR |
| Tanton21 | Tanzania | 2004, 2006 | HIV-1/HSV-2 seropositive women | Suppressive (acyclovir 400 mg twice daily until censoring) | 6, 12 and 24 month visits, 24 months | Cervicovaginal lavage | 425 | 0.03 (−0.11, 0.16) | RT-PCR |
| Zuckerman22 | Lima, Peru | 2003–4 | HIV-1/HSV-2 coinfected men | Suppressive (valacyclovir 500 mg twice daily for 8 weeks) | Thrice weekly visits, 18 weeks (cross-over) | Anoscopy with Snostrips | 20 | −0.16 (−0.25, −0.07) | RT-PCR |
| Zuckerman27 | Lima, Peru | no details | HIV-1/HSV-2 coinfected men | Suppressive (valacyclovir 500 mg twice daily for 8 weeks) | Weekly visits, 18 weeks (cross-over) | Semen | 19 | −0.29 (−0.48, −0.11) | RT-PCR |
| Episodic therapy trials | |||||||||
| Mayaud23 | 3 sites in Ghana/CAR | 2003–5 | HIV-1 infected women with HSV-2 ulcers | Episodic (acyclovir 400 mg thrice daily for 5 days) | Day 7, 28 days | Cervicovaginal lavage | 89 | −0.06 (−0.40, 0.30) | RT-PCR |
| Paz-Bailey24 | Gauteng, South Africa | 2005–6 | HIV-1 infected men with HSV-2 ulcers | Episodic (acyclovir 400 mg thrice daily for 5 days) | Day 7, 28 days | Ulcer lavage | 193 | −0.82 (−1.45, −0.18) | RT-PCR |
| Phiri25 | Lilongwe, Malawi | 2004–6 | HIV-1 infected men with HSV-2 ulcers | Episodic (acyclovir 800 mg twice daily for 5 days) | Day 14, 28 days | Semen | 62 | −0.14 (−0.72, 0.44) | RT-PCR |
| HIV-1 infected women with genital ulcers | Cervical swab | 41 | −0.08 (−0.66, 0.50) | ||||||