Frequent reactivation of herpes simplex virus among HIV-1-infected patients treated with highly active antiretroviral therapy

The effect of highly active antiretroviral therapy ( HAART) on control of herpes simplex virus (HSV) in human immunodeficiency virus (HIV) type 1-infected subjects is not known. Among 28 HAART-treated and 49 untreated subjects with HIV-1 and HSV-2 infections, mucosal HSV shedding (median, 18% and 29% of days positive for HSV DNA, respectively; P = .08) and HSV DNA level ( median, 56,250 and 50,000 copies/mL, respectively; P = .20) were similar. Treated subjects reported significantly fewer days with HSV lesions, compared with untreated subjects (2.8% vs. 11.3% of days, respectively; P = .001). Thus, mucosal HSV shedding and HSV-2 reactivation were still frequent among treated subjects, even though HAART was associated with fewer days with HSV lesions.