Incident HSV-2 Infections Are Common Among HIV-1-discordant Couples

Background. The synergy between herpes simplex virus type 2 (HSV-2) and human immunodeficiency virus type 1 (HIV-1) is well known, but lack of knowledge about the epidemiology of HSV-2 acquisition in HIV-1-discordant couples hampers development of HSV-2 prevention interventions that could reduce HIV...

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Published in:The Journal of infectious diseases 2013-10, Vol.208 (7), p.1093-1101
Main Authors: Muiru, Anthony N., Guthrie, Brandon L., Bosire, Rose, Merkel, Michele, Liu, Amy Y., Choi, Robert Y., Lohman-Payne, Barbara, Gatuguta, Ann, Mackelprang, Romel D., Kiarie, James N., Farquhar, Carey
Format: Article
Language:English
Subjects:
Adult
AIDS
Biological and medical sciences
Disease risks
Enzyme-Linked Immunosorbent Assay
Family Characteristics
Female
Fundamental and applied biological sciences. Psychology
Herpes Genitalis - epidemiology
Herpes Genitalis - virology
Herpes simplex virus 2
Herpesvirus 2, Human - isolation & purification
HIV
HIV 1
HIV Infections - complications
HIV Infections - virology
HIV-1 - isolation & purification
HIV/AIDS
Human herpesvirus 2
Human immunodeficiency virus 1
Human immunodeficiency virus 2
Human viral diseases
Humans
Incidence
Infections
Infectious diseases
Kenya - epidemiology
Major and Brief Reports
Male
Medical sciences
Men
Microbiology
Miscellaneous
Prevalence
Sexual partners
Viral diseases
Viral diseases of the lymphoid tissue and the blood. Aids
Virology
Viruses
Women
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Summary:Background. The synergy between herpes simplex virus type 2 (HSV-2) and human immunodeficiency virus type 1 (HIV-1) is well known, but lack of knowledge about the epidemiology of HSV-2 acquisition in HIV-1-discordant couples hampers development of HSV-2 prevention interventions that could reduce HIV-1 transmission. Methods. HIV-1-discordant couples were enrolled in Nairobi, Kenya, and followed for up to 2 years. HSV-2 status was determined using HerpeSelect HSV-2 ELISA. Correlates of prevalence and incidence were assessed. Results. Of 469 HIV-1-discordant couples, at baseline, 353 (75.3%) were affected by HSV-2, of which 189 (53.5%) were concordantly HSV-2 seropositive and 164 (46.5%) were HSV-2-discordant. Prevalence was lowest among HIV-1-uninfected men (39.9%) compared to HIV-1-infected women (64.8%), HIV-1-infected men (66.7%), and HIV-1-uninfected women (68.5%). During follow-up, HSV-2 seroincidence was 14.9 per 100 person-years. Incidence was 1.6-fold higher among females compared to males (95% confidence interval [CI], 1.00-2.48) and 2.5-fold higher in HIV-1-infected compared to uninfected women (95% CI, 1.12-5.74). At least 30% of incident HSV-2 infections originated from an outside partner. Conclusions. The high HSV-2 prevalence and incidence in HIV-1-discordant couples in sub-Saharan Africa suggest HSV-2 treatment and prevention could be an effective targeted strategy to reduce HSV-2 and HIV-1 transmission in this high-risk population.
ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/jit303