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Apolipoprotein E-ϵ4 and recurrent genital herpes in individuals co-infected with herpes simplex virus type 2 and HIV
  1. A N Jayasuriya1,
  2. R F Itzhaki2,
  3. M A Wozniak2,
  4. R Patel3,
  5. E J Smit1,
  6. R Noone2,
  7. G Gilleran1,
  8. S Taylor1,
  9. D J White1
  1. 1
    Birmingham Heartlands Hospital, Birmingham, UK
  2. 2
    University of Manchester, Manchester, UK
  3. 3
    University of Southampton, Southampton, UK
  1. Dr Ashini Jayasuriya, Department of Genito-Urinary Medicine, Hawthorn House, Heartlands Hospital, Bordsley Green East, Birmingham B9 5SS, UK; ashini{at}


Apolipoprotein E (APOE) alleles have been associated with the severity of, or susceptibility to, infection by various microbes. We investigated the potential association between the APOE-ϵ4 allele and the rate of recurrence of genital herpes in patients who were HIV positive and herpes simplex virus type 2 (HSV-2) seropositive. The APOE-ϵ4 allele was significantly associated with recurrent genital ulceration independent of ethnicity, antiretroviral therapy and CD4 count (OR 8.3; 95% CI 2.4 to 28.5). To our knowledge, this is the first published study to demonstrate this association and suggests that APOE-ϵ4 may represent a future prognostic marker for symptomatic recurrence of genital herpes in individuals with HIV.

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  • Figure 1 and table 2 are published online only at

  • Funding: The Birmingham Heartlands Hospital Hawthorn House Trust Fund.

  • Competing interests: None.

  • Ethics approval: Ethics approval was obtained from the East Birmingham Local Research Ethics Committee.

  • Contributors: ANJ designed the study, collected and analysed the data and wrote the paper. RFI designed the study and reviewed the paper. MAW was the principal scientist. RP contributed to the study design and reviewed the paper. EJS contributed to the study design and practical implementation. RN performed the allele typing. GG recruited patients and collected samples. ST contributed to study design and reviewed the paper. DJW designed the study and reviewed the paper.