Changes in the Soluble Mucosal Immune Environment during Genital Herpes Outbreaks.

Publication Type:

Journal Article


Journal of acquired immune deficiency syndromes (1999), Volume 61, Issue 2, p.194-202 (2012)


2012, August 2012, Center-Authored Paper, Vaccine and Infectious Disease Division


BACKGROUND:: Genital tract secretions provide variable inhibitory activity against herpes simplex virus (HSV) ex vivo. We hypothesize that the anti-HSV activity may prevent the spread of virus from the more commonly affected sites, such as the external genitalia, to the upper genital tract. METHODS:: The antimicrobial activity of cervicovaginal lavage (CVL) and concentrations of mucosal immune mediators were measured in ten HIV-seronegative women with an active external herpetic lesion and compared to ten HIV-seronegative women who were HSV-1 and HSV-2 seronegative. Samples were obtained at the time of a symptomatic external lesion (day 0), following one week of oral acyclovir (ACV) (day 7), and one week after completing treatment (day 14).Controls were evaluated at parallel intervals. RESULTS:: The anti-HSV activity was higher in CVL obtained from cases compared to controls at presentation (Day 0) (54.3% vs. 28%), fell to similar levels on Day 7, and then rebounded on Day 14 (69% vs. 25%). The anti-HSV activity correlated positively and significantly with the concentrations of several inflammatory proteins; the concentrations of these proteins tended to be higher in cases compared to controls and followed a similar temporal pattern. CONCLUSIONS:: Increases in inflammatory immune mediators and anti-HSV activity were detected in CVL at the time of clinical outbreaks and following completion of a short course of ACV. These mucosal responses may protect against HSV spread, but could facilitate HIV infection and contribute to the clinical observation that, independent of clinical lesions, HSV-2 is a risk factor for HIV acquisition.