Seroprevalence and risk factors for herpes simplex virus infection in a population of HIV-infected patients in Canada.
OBJECTIVE
To determine the seroprevalence of herpes simplex virus infection in a population of HIV-infected individuals in Canada.


METHODS
HIV-infected patients attending 5 infectious disease clinics for follow-up care were approached to participate in the study. After informed consent was obtained, subjects completed a questionnaire documenting HIV-risk behavior, duration of infection, history of oral and/or genital herpes, and treatment for HIV and/or genital herpes. Blood for HSV type-specific serology was drawn and tested by enzyme-linked immunosorbent assay (Focus Diagnostics HerpeSelect HSV-1, HSV-2 enzyme-linked immunosorbent assay IgG). Equivocal samples were repeated and any discrepant results were resolved with Western blot.


RESULTS
Six hundred twenty-nine HIV-infected individuals participated. The mean age was 43.9 years, 74.7% were Canadian born and 72.3% were men. The majority of foreign-born subjects were black (endemic) and women. The seroprevalence of HSV-1 and HSV-2 was 78.1% and 54.6%, respectively. Women were 2.7 times more likely to be HSV-2 seropositive, non-Canadian-born participants were 2.0 times more likely to be HSV-2 seropositive, and nonwhite subjects were 3.2 times more likely to be seropositive. Men who had sex with other men had the lowest seroprevalence of HSV-2. Only 30.3% of HSV-2 positive subjects reported a history of genital herpes.


CONCLUSIONS
A significant proportion of HIV-infected subjects attending 5 infectious disease clinics in Canada are coinfected with HSV. Routine type-specific HSV-2 testing should be introduced to direct education regarding symptoms, signs, and transmission reduction of genital herpes and perhaps ultimately HIV-1. Knowledge of HSV serostatus would also provide an opportunity to consider antiviral therapy.
Romanowski
Barbara
B
Department of Medicine, University of Alberta, Edmonton, Alberta, Canada. broman@docromanowski.com
Myziuk
Linda N
LN
Walmsley
Sharon L
SL
Trottier
Sylvie
S
Singh
Ameeta E
AE
Houston
Stanley
S
Joffe
Mark
M
Chiu
Isabelle
I
D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood*; D002170:Canada / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D006558:Herpes Genitalis / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D006561:Herpes Simplex / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D018259:Herpesvirus 1, Human / Q000276:immunology*; D018258:Herpesvirus 2, Human / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D055815:Young Adult
D000914:Antibodies, Viral