Genital Herpes and HSV-HIV Interactions: Moving Forward

Genital herpes is a chronic, lifelong infection that is highly prevalent: approximately 1 in 5 adults in the U.S. has genital infection with herpes simplex virus type 2 (HSV-2), as do over 40% of U.S. STD clinic patients. A growing body of epidemiologic and biologic data indicates that HSV-2 infection increases the risk of both acquiring and transmitting HIV infection. The largest body of evidence relates to HSV-2 and HIV acquisition: two large meta-analyses, involving more than 35 epidemiologic studies, have demonstrated that HSV-2 infection is associated with a 2- to 4-fold increased risk of HIV acquisition. These data have led to development of “proof of concept” intervention trials, to determine whether daily therapy to suppress HSV infection can reduce the risk of HIV acquisition or transmission among HSV-2-seropositive persons. The HIV Prevention Trials Network Protocol 039 (HPTN 039) study is the largest randomized controlled trial to date assessing the impact of HSV-2 suppressive therapy on the risk of HIV acquisition. The long-anticipated HPTN 039 study results will be available in early 2008. The findings from this trial will have important implications for STD and HIV prevention programs and will reinvigorate the discussion of the role of genital herpes prevention in STD control programs. This session will begin with a presentation of the results of the HPTN 039 study and a discussion of the implications of the study findings with respect to HSV and HIV prevention, especially in the United States. Following will be an overview of current data and issues related to HSV management and prevention. Optimal management and prevention strategies will be explored, along with a discussion of whether the findings from the HPTN 039 study influence various programmatic approaches. The last talk will address the practical considerations related to operationalizing HSV control measures and integrating them into local programs, with an emphasis on HSV serologic testing, medications, counseling, and costs.
Wednesday, March 12, 2008: 2:00 PM-3:30 PM
International Ballroom North
2:40 PM
Genital Herpes Prevention: Implications for Local STD Programs
Susan Blank, MD, MPH, NYC DOHMH / Division of STD Prevention, CDC
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