Genital herpes and HIV infection: Can we still exploit the intimate relationship?

Abstract

South Africa is suffering the most severe HIV epidemic on earth. Prior to emergence of HIV/AIDS, conventional sexually transmitted infections (STIs) were endemic in many underprivileged communities as a result of many social factors. Since conventional STIs may act as co-factors in both acquisition and transmission of HIV, it was initially thought that improved treatment of these infections would result in a reduction of HIV transmission. As the HIV epidemic matured, the aetiological agents causing genital ulcer disease changed, with genital herpes emerging as the most potent STI co-factor in HIV spread. Despite learning more about herpes simplex virus/HIV interactions, attempts to utilise this knowledge to design HIV prevention strategies proved disappointing. However, the lessons learned may prove to be valuable in the future.