Progressive Hypertrophic Genital Herpes in an HIV-Infected Woman despite Immune Recovery on Antiretroviral Therapy

• Main Authors: Mark H. Yudin (Author), Rupert Kaul (Author)
• Format: Book
• Published: Hindawi Limited, 2008-01-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 1064-7449; 1098-0997; 10.1155/2008/592532
• Keywords: Gynecology and obstetrics; RG1-991; Infectious and parasitic diseases; RC109-216
• Source: Infectious Diseases in Obstetrics and Gynecology, Vol 2008 (2008)

Most HIV-infected individuals are coinfected by Herpes simplex virus type 2 (HSV-2). HSV-2 reactivates more frequently in HIV-coinfected individuals with advanced immunosuppression, and may have very unusual clinical presentations, including hypertrophic genital lesions. We report the case of a progressive, hypertrophic HSV-2 lesion in an HIV-coinfected woman, despite near-complete immune restoration on antiretroviral therapy for up to three years. In this case, there was prompt response to topical imiquimod. The immunopathogenesis and clinical presentation of HSV-2 disease in HIV-coinfected individuals are reviewed, with a focus on potential mechanisms for persistent disease despite apparent immune reconstitution. HIV-infected individuals and their care providers should be aware that HSV-2 may cause atypical disease even in the context of near-comlpete immune reconstitution on HAART.