THE IMPACT OF ACTIVE HERPES-SIMPLEX VIRUS-INFECTION ON HUMAN-IMMUNODEFICIENCY-VIRUS LOAD

The effect of a concurrent herpes simplex virus (HSV) infection on hum an immunodeficiency virus type 1 (HIV-1) load was evaluated. Sixteen s ubjects were identified with an active HSV infection and had pre-outbr eak, acute-phase, and post-outbreak plasma (n = 16) and peripheral blo od mononuclear cell (PBMC) (n = 8) samples for evaluation. All subject s were treated for an acute HSV outbreak with acyclovir for 10 days, f ollowed by chronic prophylaxis. HIV-1 plasma RNA levels were determine d by branched DNA, and intracellular HIV gag mRNA copy numbers were de termined by quantitative reverse transcriptase-polymerase chain reacti on ELISA, Plasma virus load increased a median of 3.4-fold during the acute outbreak (range, 0- to 10-fold; P=.002), while post-outbreak lev els (30-45 days after the appearance of lesions) remained above pre-ou tbreak, baseline levels in some subjects, Intracellular HIV gag mRNA i ncreased during the outbreak as well. Thus, an acute HSV episode can r esult in increased HIV transcription and plasma virus load.