{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T04:10:49Z","timestamp":1784175049689,"version":"3.55.0"},"reference-count":31,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2013,11,5]]},"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Herpes simplex virus types 1 and 2 (HSV-1\/2) may have adverse consequences on HIV type 1 infection. We quantified the frequency of HSV reactivations in highly active antiretroviral therapy (HAART)-treated adults with HIV, and compared it with that in HAART-na\u00efve patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>2 academic hospital sites in Toronto, Canada.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Asymptomatic HAART-naive (n=44) or treated (with HIV RNA &lt;50 copies\/mL, n=41) adults with HSV-1 and\/or 2, HIV coinfection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>HSV-1 and HSV-2 shedding as measured by PCR on oral, genital and anal swabs self-collected daily for 28\u2005days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 85 participants, 88%, 67% and 53% were coinfected with HSV-1, HSV-2 and both HSV types, respectively. Median (IQR) CD4 count was 516 (382, 655) cells\/mm\n                      <jats:sup>3<\/jats:sup>\n                      . HSV (type 1 and\/or 2) shedding occurred on a median (IQR) of 7.1% (0, 17.9%) of days in HAART users and 3.6% (0, 10.7%) of days in non-HAART users. No significant relationship was observed between HAART and HSV-1\/2 shedding in univariable (OR=1.55, 95% CI 0.83 to 2.87) or multivariable negative binomial models adjusted for sex, baseline CD4 count, recent immigrant status and time since HIV diagnosis (adjusted OR, aOR=1.05, 95% CI 0.43 to 2.58). Similar null results were observed for HSV-2 shedding in HSV-2 seropositive participants (aOR=1.16, 95% CI 0.40 to 3.36) and HSV-1 shedding in HSV-1 seropositive participants (aOR=0.70, 95% CI 0.14 to 3.47).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>HSV reactivations persist despite suppressive HAART among adults coinfected with HSV and HIV. Clinical trials of suppressive anti-HSV therapy are warranted in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2013-004210","type":"journal-article","created":{"date-parts":[[2014,1,25]],"date-time":"2014-01-25T20:13:15Z","timestamp":1390680795000},"page":"e004210","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":27,"title":["Antiretroviral therapy is not associated with reduced herpes simplex virus shedding in HIV coinfected adults: an observational cohort study"],"prefix":"10.1136","volume":"4","author":[{"given":"Darrell H S","family":"Tan","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, St Michael's Hospital, Toronto, Ontario, Canada"},{"name":"Division of Infectious Diseases, University Health Network, Toronto, Ontario, Canada"},{"name":"Department of Medicine, University of Toronto, Toronto, Ontario, Canada"},{"name":"Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet M","family":"Raboud","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University Health Network, Toronto, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rupert","family":"Kaul","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University Health Network, Toronto, Ontario, Canada"},{"name":"Department of Medicine, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon L","family":"Walmsley","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University Health Network, Toronto, Ontario, Canada"},{"name":"Department of Medicine, University of Toronto, Toronto, Ontario, Canada"},{"name":"Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2014,1,24]]},"reference":[{"key":"2025120618585286000_4.1.e004210.1","doi-asserted-by":"publisher","DOI":"10.1086\/345771"},{"key":"2025120618585286000_4.1.e004210.2","doi-asserted-by":"publisher","DOI":"10.1086\/589621"},{"key":"2025120618585286000_4.1.e004210.3","doi-asserted-by":"publisher","DOI":"10.1086\/587697"},{"key":"2025120618585286000_4.1.e004210.4","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0019947"},{"key":"2025120618585286000_4.1.e004210.5","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit208"},{"key":"2025120618585286000_4.1.e004210.6","doi-asserted-by":"publisher","DOI":"10.1086\/314486"},{"key":"2025120618585286000_4.1.e004210.7","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-123-11-199512010-00006"},{"key":"2025120618585286000_4.1.e004210.8","doi-asserted-by":"publisher","DOI":"10.1097\/00126334-200404150-00001"},{"key":"2025120618585286000_4.1.e004210.9","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-199211000-00012"},{"key":"2025120618585286000_4.1.e004210.10","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)62038-9"},{"key":"2025120618585286000_4.1.e004210.11","unstructured":"Impact of HSV-2 suppressive therapy with daily acyclovir on HIV-1 disease progression: a randomized placebo-controlled trial in Rakai, Uganda. 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