Co-infection with herpesviruses such as herpes simplex virus type 2 (HSV-2) and cytomegalovirus (CMV) is common in HIV-infected adults, at an approximate prevalence of 55% and 85% respectively in Canadian populations. In HIV co-infected adults, HSV-2 and CMV reactivations have been linked to increased HIV viral load, systemic inflammation and T-cell activation, even when reactivations are asymptomatic. HIV patients hospitalized with acute opportunistic infections and other acute illnesses thus represent a subgroup at particular risk for adverse short-term health outcomes, but the relative importance of subclinical herpesvirus reactivations in this group has been inadequately studied.
The primary objective of the study will therefore be to assess the feasibility of collecting serial mucosal, serial blood and as-indicated respiratory specimens for the detection of herpesviruses (specifically, HSV-2 and CMV) from HIV-infected adults admitted to an acute care hospital with an acute illness or opportunistic infection. Secondary objectives are to quantify shedding of these viruses in distinct anatomic sites (oral mucosa, genital mucosa, anal mucosa, blood, respiratory secretions), and to determine the magnitude of association between shedding of either herpesvirus with hospital length of stay.
This study was made possible by a grant from the Canadian HIV Trials Network.