PMID- 26704611 OWN - NLM STAT- MEDLINE DCOM- 20160927 LR - 20181217 IS - 1537-6613 (Electronic) IS - 0022-1899 (Print) IS - 0022-1899 (Linking) VI - 213 IP - 10 DP - 2016 May 15 TI - Transient Increase in Herpes Simplex Virus Type 2 (HSV-2)-Associated Genital Ulcers Following Initiation of Antiretroviral Therapy in HIV/HSV-2-Coinfected Individuals. PG - 1573-8 LID - 10.1093/infdis/jiv765 [doi] AB - BACKGROUND: Immune reconstitution inflammatory syndrome (IRIS) in human immunodeficiency virus (HIV)-infected persons beginning antiretroviral therapy (ART) has been incompletely characterized for herpes simplex virus type 2 (HSV-2). METHODS: We evaluated genital ulcer disease (GUD) and HSV-2-associated GUD at quarterly visits or when spontaneously reported at monthly visits in 3381 HIV/HSV-2-coinfected individuals in a placebo-controlled trial of suppressive acyclovir therapy to prevent HIV transmission, 349 of whom initiated ART during the study. Incidence was calculated for months before and after ART initiation, and incidence rate ratios (IRRs) were calculated. RESULTS: GUD incidence increased from 15.0 episodes per 100 person-years before ART to 26.9 episodes per 100 person-years in the first full quarter after ART initiation (IRR, 1.83;P= .03), and the incidence of HSV-2-associated GUD increased from 8.1 to 19.0 episodes per 100 person-years (IRR, 2.20;P= .02). Subsequently, the incidence of GUD was similar to that before ART, although the numbers were small. Persons receiving suppressive acyclovir had fewer GUD episodes, but the IRR after beginning ART was similar in the acyclovir and placebo groups. CONCLUSIONS: Initiation of ART in HIV/HSV-2-coinfected persons is associated with a transient increase in GUD and HSV-2 GUD. Acyclovir reduces the incidence of GUD but does not prevent an increase in GUD incidence during the first quarter following initiation of ART. CI - (c) The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com. FAU - Fife, Kenneth H AU - Fife KH AD - Department of Medicine Deparment of Microbiology and Immunology Department of Pathology, Indiana University, Indianapolis. FAU - Mugwanya, Kenneth AU - Mugwanya K AD - Department of Epidemiology. FAU - Thomas, Katherine K AU - Thomas KK AD - Department of Global Health. FAU - Baeten, Jared M AU - Baeten JM AD - Department of Epidemiology Department of Global Health Department of Medicine. FAU - Celum, Connie AU - Celum C AD - Department of Epidemiology Department of Global Health Department of Medicine. FAU - Bukusi, Elizabeth AU - Bukusi E AD - Center for Microbiology Research, Kenya Medical Research Institute, Nairobi. FAU - de Bruyn, Guy AU - de Bruyn G AD - Sanofi Pasteur, Swiftwater, Pennsylvania. FAU - Mujugira, Andrew AU - Mujugira A AD - Department of Epidemiology Department of Global Health. FAU - Vwalika, Bellington AU - Vwalika B AD - Department of Obstetrics and Gynaecology, University of Zambia, and Zambia-Emory HIV Research Project, Lusaka. FAU - Wald, Anna AU - Wald A AD - Department of Epidemiology Department of Medicine Department of Laboratory Medicine, University of Washington, and Vaccine and Infectious Disease Institute, Fred Hutchinson Cancer Research Center, Seattle, Washington. FAU - Lingappa, Jairam R AU - Lingappa JR AD - Department of Global Health Department of Medicine Department of Pediatrics. CN - Partners in Prevention HSV/HIV Transmission Study Team LA - eng GR - P01 AI057005/AI/NIAID NIH HHS/United States PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20151223 PL - United States TA - J Infect Dis JT - The Journal of infectious diseases JID - 0413675 RN - X4HES1O11F (Acyclovir) SB - IM MH - Acyclovir/adverse effects/therapeutic use MH - Adult MH - Antiretroviral Therapy, Highly Active/*adverse effects MH - Coinfection MH - Female MH - HIV Infections/complications/*drug therapy/epidemiology MH - Herpes Genitalis/complications/*drug therapy/epidemiology MH - Herpesvirus 2, Human/*isolation & purification MH - Humans MH - Immune Reconstitution Inflammatory Syndrome/drug therapy/*epidemiology MH - Incidence MH - Male MH - Middle Aged MH - Ulcer/complications/drug therapy/*epidemiology PMC - PMC6281349 OTO - NOTNLM OT - acyclovir OT - antiretroviral therapy OT - herpes simplex virus OT - human immunodeficiency virus FIR - Celum, Connie IR - Celum C FIR - Wald, Anna IR - Wald A FIR - Lingappa, Jairam IR - Lingappa J FIR - Baeten, Jared M IR - Baeten JM FIR - Campbell, Mary IR - Campbell M FIR - Corey, Lawrence IR - Corey L FIR - Coombs, Robert W IR - Coombs RW FIR - Hughes, James P IR - Hughes JP FIR - Magaret, Amalia IR - Magaret A FIR - McElrath, M Juliana IR - McElrath MJ FIR - Morrow, Rhoda IR - Morrow R FIR - Mullins, James I IR - Mullins JI FIR - Coetzee, David IR - Coetzee D FIR - Fife, Kenneth IR - Fife K FIR - Were, Edwin IR - Were E FIR - Essex, Max IR - Essex M FIR - Makhema, Joseph IR - Makhema J FIR - Katabira, Elly IR - Katabira E FIR - Ronald, Allan IR - Ronald A FIR - Allen, Susan IR - Allen S FIR - Kayitenkore, Kayitesi IR - Kayitenkore K FIR - Karita, Etienne IR - Karita E FIR - Bukusi, Elizabeth IR - Bukusi E FIR - Cohen, Craig IR - Cohen C FIR - Allen, Susan IR - Allen S FIR - Kanweka, William IR - Kanweka W FIR - Allen, Susan IR - Allen S FIR - Vwalika, Bellington IR - Vwalika B FIR - Kapiga, Saidi IR - Kapiga S FIR - Manongi, Rachel IR - Manongi R FIR - Farquhar, Carey IR - Farquhar C FIR - John-Stewart, Grace IR - John-Stewart G FIR - Kiarie, James IR - Kiarie J FIR - Allen, Susan IR - Allen S FIR - Inambao, Mubiana IR - Inambao M FIR - Delany-Moretlwe, Sinead IR - Delany-Moretlwe S FIR - Rees, Helen IR - Rees H FIR - de Bruyn, Guy IR - de Bruyn G FIR - Gray, Glenda IR - Gray G FIR - McIntyre, James IR - McIntyre J FIR - Mugo, Nelly Rwamba IR - Mugo NR EDAT- 2015/12/26 06:00 MHDA- 2016/09/28 06:00 PMCR- 2017/05/15 CRDT- 2015/12/26 06:00 PHST- 2015/09/29 00:00 [received] PHST- 2015/12/18 00:00 [accepted] PHST- 2015/12/26 06:00 [entrez] PHST- 2015/12/26 06:00 [pubmed] PHST- 2016/09/28 06:00 [medline] PHST- 2017/05/15 00:00 [pmc-release] AID - jiv765 [pii] AID - 10.1093/infdis/jiv765 [doi] PST - ppublish SO - J Infect Dis. 2016 May 15;213(10):1573-8. doi: 10.1093/infdis/jiv765. Epub 2015 Dec 23.