Prevalence- and gender-specific immune response to opportunistic infections in HIV-infected patients in Lesotho.
BACKGROUND
The objective of this study was to assess the seroprevalence of coinfecting viruses and Treponema pallidum (T. pallidum) in a cohort of 205 antiretrovirally treated HIV-infected individuals (152 females and 53 males, aged: 19-71 years) in rural Lesotho. Furthermore agent-specific immune responses were investigated by analyzing antibody titers against herpes simplex virus type 2 (HSV-2) and against T. pallidum.


METHODS
Serum samples were tested by enzyme-linked immunosorbent assay for antibodies against HSV-2, cytomegalovirus, hepatitis A, B, and C viruses, and T. pallidum.


RESULTS
Seroprevalences (95% confidence intervals) were found to be 100% (98.5%-100%) for anti-cytomegalovirus, 98.5% (95.7%-99.7%) for anti-hepatitis A virus, 35.5% (28.9%-42.6%) for anti-HBc, 5.5% (2.8%-9.6%) for hepatitis B surface antigen, and 0.5% (0.0%-2.8%) for anti-hepatitis C virus. Only 78.5% (72.2%-84.0%) were anti-HSV-2 positive and 29.0% (22.8%-35.8%) had antibodies against T. pallidum. Only anti-HSV-2 titers showed gender- and CD4 cell-count dependent differences: females with >500 CD4 cells/microL had an average anti-HSV-2 titer of 446 compared with males of 398 AU/mL (not significant), but in those with 250 to 500 CD4 cells/microL, there was a significant difference with a mean titer of 467 compared to 302 AU/mL in males (P = 0.001).


CONCLUSIONS
A high seroprevalence of CMV, HAV, and HBV was found in both genders. One-third of the patients had been exposed to HBV and T. pallidum. The generally high HSV-2 prevalence showed gender- and CD4 cell count-dependent differences in HSV-2 antibody titer.
Institute of Medical Virology, Hospital of the Goethe University Frankfurt, Frankfurt am Main, Germany. rabenau@em.uni-frankfurt.de
Holger F
HF
Rabenau
Tessa
T
Lennemann
Claudia
C
Kircher
Lutz
L
Gürtler
Schlomo
S
Staszewski
Wolfgang
W
Preiser
Piet
P
McPherson
Regina
R
Allwinn
Hans Wilhelm
HW
Doerr
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology* / Q000209:etiology / Q000276:immunology; D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood*; D000914:Antibodies, Viral / Q000097:blood*; D018791:CD4 Lymphocyte Count; D005260:Female; D006678:HIV / Q000276:immunology; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology* / Q000276:immunology / Q000821:virology; D006558:Herpes Genitalis / Q000150:complications / Q000453:epidemiology / Q000276:immunology / Q000821:virology; D018258:Herpesvirus 2, Human / Q000276:immunology; D006801:Humans; D007927:Lesotho / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D016036:Seroepidemiologic Studies; D012737:Sex Factors; D013587:Syphilis / Q000150:complications / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology; D014210:Treponema pallidum / Q000276:immunology; D014777:Virus Diseases / Q000150:complications / Q000453:epidemiology* / Q000276:immunology / Q000821:virology
D000907:Antibodies, Bacterial; D000914:Antibodies, Viral