Herpes simplex virus type 2 trends in relation to the HIV epidemic in northern Malawi.
OBJECTIVE
It is unclear whether the high prevalence of herpes simplex virus type 2 (HSV-2) found in much of Africa predates the HIV epidemic or is, to some extent, a consequence of it. HSV-2 prevalence trends in a rural African community were assessed over a period in which HIV prevalence rose sharply, and antenatal clinic (ANC) surveillance was explored as a method of estimating community HSV-2 prevalence.


METHODS
HSV-2 seroprevalence was determined among community controls seen for case-control studies of mycobacterial disease in Karonga district, Malawi, in 1988-90, 1998-2001 and 2002-5, and in women attending ANC as part of surveillance for HIV in 1999-2000. Over this period HIV prevalence rose from 4% to 12%.


RESULTS
HSV-2 prevalence in all periods increased sharply with age and was higher in women than in men. After excluding migrants, there was no evidence of change in HSV-2 prevalence in the different periods. Women in the ANC group had lower HSV-2 prevalence than those in the community, but the ANC prevalence was a good approximation to the combined male and female prevalence for the same age group.


CONCLUSIONS
This study suggests that HSV-2 was already widespread before the HIV epidemic and has not been greatly influenced by it. It also demonstrates that ANC surveillance may be useful for estimating community HSV-2 prevalence.
Infectious Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E7HT, UK. judith.glynn@lshtm.ac.uk
J R
JR
Glynn
A C
AC
Crampin
B M M
BM
Ngwira
R
R
Ndhlovu
O
O
Mwanyongo
P E M
PE
Fine
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology*; D006558:Herpes Genitalis / Q000150:complications / Q000453:epidemiology*; D018258:Herpesvirus 2, Human; D006801:Humans; D008295:Malawi / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012423:Rural Health; D012959:Socioeconomic Factors