title: Prevalence and risk factors associated with herpes simplex virus-2 infection in a contemporary cohort of HIV-infected persons in the United States.
abstract: BACKGROUND
  We compared the herpes simplex virus type 2 (HSV-2) seroprevalence in a contemporary HIV cohort with the general US population and determined risk factors for HSV-2 infection among HIV-infected persons.
  
  
  METHODS
  The Study to Understand the Natural History of HIV and AIDS in the Era of Effective Therapy (SUN) Study is a prospective observational cohort of 700 HIV-infected adults enrolled in 4 U.S. cities between 2004 and 2006. At baseline, participants completed a behavioral risk questionnaire and provided specimens for HSV-2 serology. We calculated HSV-2 seroprevalence, standardized by age, gender, and race among HIV-infected persons compared with the general US adult population, using data from the National Health and Nutrition Examination Survey from 2003 to 2006. We examined risk factors associated with HSV-2 infection among HIV-infected persons using multivariate logistic regression.
  
  
  RESULTS
  Among 660 (94%) SUN participants with adequate specimens for HSV-2 serologic testing, 548 (83%) were 20 to 49 years old (median age, 39 years; 77% male; 59% non-Hispanic white; median CD4 count, 470 cells/mm; 74% with HIV RNA viral loads <400 copies/mL). HSV-2 seroprevalence was significantly higher among HIV-infected adults (59.7%, 95% confidence interval: 55.8-63.6) compared with the general US population (19.2%, 95% confidence interval: 17.5-21.1). In multivariate analysis, we found that older age, female gender, black non-Hispanic race/ethnicity, being currently unemployed, high-risk anal HPV infection, and longer duration since HIV diagnosis were associated with significantly higher odds of HSV-2 infection.
  
  
  CONCLUSIONS
  HSV-2 seroprevalence is 3 times as high among HIV-infected adults as in the general U.S. population. Clinicians should be aware that increased risk for HSV-2 infection was distributed broadly among HIV-infected persons and not limited to those with high-risk sexual behaviors.
authors.affiliation: Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. plp3@cdc.gov
authors.forename: Pragna
authors.initials: P
authors.lastname: Patel
authors.forename: Tim
authors.initials: T
authors.lastname: Bush
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Mayer
authors.forename: Sheila
authors.initials: S
authors.lastname: Desai
authors.forename: Keith
authors.initials: K
authors.lastname: Henry
authors.forename: Edgar Turner
authors.initials: ET
authors.lastname: Overton
authors.forename: Lois
authors.initials: L
authors.lastname: Conley
authors.forename: John
authors.initials: J
authors.lastname: Hammer
authors.forename: John T
authors.initials: JT
authors.lastname: Brooks
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006558:Herpes Genitalis / Q000453:epidemiology*; D018258:Herpesvirus 2, Human / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D055815:Young Adult