Incident and prevalent herpes simplex virus type 2 infection increases risk of HIV acquisition among women in Uganda and Zimbabwe.
AIDS
; 21(12): 1515-23, 2007 Jul 31.
Article
en En
| MEDLINE
| ID: mdl-17630545
ABSTRACT
BACKGROUND:
An association has been demonstrated between herpes simplex type 2 (HSV-2) and HIV infection among men, but prospective studies in women have yielded mixed results.OBJECTIVE:
To estimate the effects of prevalent and incident HSV-2 infection on subsequent HIV acquisition among women in two African countries.DESIGN:
Prospective cohort study.METHODS:
HSV-2 and HIV serostatus were evaluated at enrollment and quarterly for 15-24 months among 4531 sexually active, HIV-uninfected women aged 18-35 years from Uganda and Zimbabwe. The association between prior HSV-2 infection and HIV acquisition was estimated using a marginal structural discrete survival model, adjusted for covariates.RESULTS:
HSV-2 seroprevalence at enrollment was 52% in Uganda and 53% in Zimbabwe; seroincidence during follow-up was 9.6 and 8.8/100 person-years in Uganda and Zimbabwe, respectively. In Uganda, the hazard ratio (HR) for HIV was 2.8 [95% confidence interval (CI), 1.5-5.3] among women with seroprevalent HSV-2 and 4.6 (95% CI, 1.6-13.1) among women with seroincident HSV-2, adjusted for confounding. In Zimbabwe, the HR for HIV was 4.4 (95% CI, 2.7-7.2) among women with seroprevalent HSV-2, and 8.6 (95% CI, 4.3-17.1) among women with seroincident HSV-2, adjusted for confounding. The population attributable risk percent for HIV due to prevalent and incident HSV-2 infection was 42% in Uganda and 65% in Zimbabwe.CONCLUSIONS:
HSV-2 plays an important role in the acquisition of HIV among women. Efforts to implement known HSV-2 control measures, as well as identify additional measures to control HSV-2, are urgently needed to curb the spread of HIV.
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Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Herpes Genital
/
Infecciones por VIH
Tipo de estudio:
Clinical_trials
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Adult
/
Female
/
Humans
País/Región como asunto:
Africa
Idioma:
En
Revista:
AIDS
Asunto de la revista:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Año:
2007
Tipo del documento:
Article
País de afiliación:
Estados Unidos