Medical male circumcision and herpes simplex virus 2 acquisition: posttrial surveillance in Kisumu, Kenya.
J Infect Dis
; 208(11): 1869-76, 2013 Dec 01.
Article
em En
| MEDLINE
| ID: mdl-23901089
ABSTRACT
BACKGROUND:
We estimated the 72-month efficacy of medical male circumcision (MMC) against herpes simplex virus 2 (HSV-2) incidence among men in the Kisumu MMC randomized trial.METHODS:
From 2002 to 2005, 2784 men aged 18-24 were enrolled and randomized 11 to immediate circumcision or control. Cox proportional hazards regression incorporating stabilized inverse probability of treatment and censoring weights generated through marginal structural modeling was used to estimate the efficacy of MMC on HSV-2 risk. Conventional conditional Cox regression identified multivariable risks for HSV-2 seroconversion.RESULTS:
Among 2044 HSV-2 seronegative men at baseline, the cumulative 72-month HSV-2 incidence was 33.5% (32.7% among circumcised men, 34.6% among uncircumcised men). In weight-adjusted Cox regression, the hazard ratio was 0.88 (95% confidence interval, .77-1.10). In multivariable analyses, risks for HSV-2 included human immunodeficiency virus (HIV) infection, genital ulcer disease (GUD), penile epithelial trauma, multiple recent sex partners, and being married /cohabiting.CONCLUSIONS:
MMC had no effect on acquisition of HSV-2 during 72 months of follow-up. The temporal sequence and limited correlation between HSV-2, GUD, and penile epithelial trauma suggests that these are distinct phenomena rather than misclassification of HSV-2 symptoms. Determining the etiology of non-sexually transmitted infection GUD and penile epithelial trauma is needed, as both are commonly occurring risks for HSV-2 and HIV acquisition. CLINICAL TRIALS REGISTRATION NCT0005937.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Herpes Genital
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Circuncisão Masculina
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Herpesvirus Humano 2
Tipo de estudo:
Clinical_trials
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Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
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Screening_studies
Limite:
Adolescent
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Adult
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Humans
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Male
País como assunto:
Africa
Idioma:
En
Ano de publicação:
2013
Tipo de documento:
Article