title: Human immunodeficiency virus acquisition associated with genital ulcer disease and herpes simplex virus type 2 infection: a nested case-control study in Rakai, Uganda.
abstract: To assess the timing of symptomatic genital ulcer disease (GUD) relative to human immunodeficiency virus (HIV) seroconversion, we studied 248 case subjects who underwent HIV seroconversion and 496 HIV-negative control subjects, at 3 interview visits conducted at 10-month intervals: visit 1, before HIV acquisition; visit 2, after seroconversion; and visit 3, 10 months after detection of seroconversion. Odds ratios (ORs) and 95% confidence intervals (CIs), for HIV acquisition, were estimated by logistic regression. HIV load was measured by RNA-polymerase chain reaction, and herpes simplex virus type 2 (HSV-2) serologic testing used HerpeSelect EIA with Western blot confirmation. The OR of HSV-2 seropositivity associated with HIV acquisition was 1.7 (95% CI, 1.2-2.4). Prevalence of GUD was increased among case subjects, at visits 2 (OR, 3.2; 95% CI, 1.9-5.3) and 3 (OR, 2.1; 95% CI, 1.1-3.9). HIV load was increased in HSV-2-seropositive case subjects, compared with that in HSV-2-seronegative subjects, at 5 (P=.04) and 15 (P=.02) months after seroconversion. HIV acquisition is associated with HSV-2 seropositivity, and GUD is increased after seroconversion. HIV load is increased in HSV-2-positive subjects who seroconverted, suggesting a role for treatment of HSV-2 infection in HSV-2-seropositive, dually infected individuals.
authors: Institute of Public Health, Makerere University, Kampala, Uganda.
authors: David
authors: D
authors: Serwadda
authors: Ronald H
authors: RH
authors: Gray
authors: Nelson K
authors: NK
authors: Sewankambo
authors: Fred
authors: F
authors: Wabwire-Mangen
authors: Michael Z
authors: MZ
authors: Chen
authors: Thomas C
authors: TC
authors: Quinn
authors: Tom
authors: T
authors: Lutalo
authors: Noah
authors: N
authors: Kiwanuka
authors: Godfrey
authors: G
authors: Kigozi
authors: Fred
authors: F
authors: Nalugoda
authors: Mary P
authors: MP
authors: Meehan
authors: Rhoda
authors: R
authors: Ashley Morrow
authors: Maria J
authors: MJ
authors: Wawer
mesh_terms: D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D015153:Blotting, Western; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology / Q000821:virology; D006679:HIV Seropositivity; D015497:HIV-1; D006558:Herpes Genitalis / Q000150:complications* / Q000453:epidemiology / Q000821:virology; D018258:Herpesvirus 2, Human / Q000276:immunology*; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000737:chemistry / Q000235:genetics; D012424:Rural Population; D014454:Uganda / Q000453:epidemiology
chemical_list: D000914:Antibodies, Viral; D012367:RNA, Viral