The impact of incident and prevalent herpes simplex virus-2 infection on the incidence of HIV-1 infection among commercial sex workers in South Africa.
This study investigated the impact of prevalent and incident HSV-2 infection on the incidence of HIV-1 infection in a cohort of female commercial sex workers in KwaZulu-Natal, South Africa. Prior to a vaginal microbicide trial, 416 women were screened for antibodies to HIV-1 and herpes simplex virus-2 (HSV-2) infections and a questionnaire was used to establish behavioral, social, and demographic characteristics. A total of 187 HIV-1-seronegative women were followed up at monthly intervals when blood was drawn and used to detect HIV-1 and HSV-2 antibodies. The median duration of follow-up was 2.2 years. At screening 50% of the women were HIV-1 seropositive and 84% were HSV-2 seropositive. The hazards of HIV-1 among women who were HSV-2 seropositive or seronegative throughout, or among those who seroconverted during the study, were not significantly different. When HSV-2 seroconversion was analyzed as a time-dependent covariate, the hazard ratio for HIV-1 seroconversion was 6.0 (95% CI: 2.6-14.0) times greater among women with incident than among women with prevalent HSV-2 infections. Drawing on other recent studies these data suggest that incident HSV-2 infection increases the risk of HIV-1 infection; the effect wanes with time since infection; and the effect is significantly greater for men than it is for women.
Ramjee
Gita
G
HIV-1 Prevention Research Unit, Medical Research Council, Durban, South Africa.
Williams
Brian
B
Gouws
Eleanor
E
Van Dyck
Eddy
E
De Deken
Bénédicte
B
Karim
Salim Abdool
SA
D000293:Adolescent; D000328:Adult; D000890:Anti-Infective Agents / Q000008:administration & dosage; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D006679:HIV Seropositivity; D015497:HIV-1; D006558:Herpes Genitalis / Q000150:complications* / Q000453:epidemiology / Q000517:prevention & control; D018258:Herpesvirus 2, Human; D006801:Humans; D008875:Middle Aged; D017137:Nonoxynol / Q000008:administration & dosage; D016016:Proportional Hazards Models; D012307:Risk Factors; D011477:Sex Work; D013019:South Africa / Q000453:epidemiology; D013997:Time Factors; D014622:Vaginal Creams, Foams, and Jellies
D000890:Anti-Infective Agents; D014622:Vaginal Creams, Foams, and Jellies; D017137:Nonoxynol