Immunological Signaling During Herpes Simplex Virus-2 And Cytomegalovirus Vaginal Shedding After Initiation Of Antiretroviral Treatment

Vaginal proinflammatory cytokine expression during herpes virus reactivation was examined in human immunodeficiency virus-infected women before and after initiation of antiretroviral therapy (ART). Vaginal swabs were screened for levels of cytokines interleukin (IL)-1 beta, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-13, tumor necrosis factor (TNF)-alpha, and interferon-gamma. The relative risk (RR) of herpes simplex virus-2 or cytomegalovirus (CMV) shedding being associated with cytokine levels above the median were estimated. Herpes simplex virus-2 shedding was significantly associated with higher levels of IL-6 (RR=1.4, P=.003) and TNF-alpha(RR=1.3, P=.010), whereas CMV shedding was associated with higher IL-6 (RR=1.3, P=.006) and IL-2 (RR=1.4, P=.01). The association of viral shedding with higher IL-6 levels suggests that herpes virus reactivation may be playing a role in immune activation after ART initiation.