title: Incidence, prevalence, and epidemiology of herpes simplex virus-2 in HIV-1-positive and HIV-1-negative adolescents.
abstract: BACKGROUND
  Several studies have assessed risk factors associated with herpes simplex virus-2 (HSV-2) prevalence in adults; however, few have focused on HSV-2 incidence, particularly in adolescents. The objective of this study was to determine HSV-2 prevalence and incidence and associated risk factors in a HIV-1-positive and at risk HIV-1-negative adolescent population.
  
  
  METHODS
  Sera were tested for HSV-2 antibodies in 518 adolescents in the Reaching for Excellence in Adolescent Care and Health cohort at baseline and again at the final follow-up visit. Prevalence at baseline and incidence (per person years) of HSV-2 infection were calculated. Furthermore, among HIV-1-positive individuals, a subgroup analysis was performed to assess risk factors for HSV-2 infection. Conditional logistic regression was used to estimate odds ratios and P values for associations between CD4+ T-cell (CD4+) count, HIV-1 viral load (VL), and HSV-2 acquisition, adjusting for antiretroviral therapy use, other sexually transmitted infections, gender, race, and number of sexual partners.
  
  
  RESULTS
  At baseline, 179 (35%) subjects were HSV-2 positive, with an additional 47 (16%) new cases being identified during a median follow-up time of 1.95 years and an incidence rate of 7.35 cases per 100 person years. Several risk factors were associated with HSV-2 prevalence (being female, non-Hispanic, uncertainty of sexual preference, and HIV-1 positive) and incidence (using drugs, alcohol, and number of new sexual partners). Among HIV-1 positives, an increase in CD4+ count by 50 cell/mm(3) (odds ratio, 1.17; 95% CI, 1.04-1.31, P = 0.008) was associated with HSV-2 acquisition.
  
  
  CONCLUSIONS
  The high prevalence and incidence of HSV-2 infection among adolescents, compared with the general population at this age group suggests a critical need for screening and preventive programs among this targeted group.
authors.affiliation: Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama 35294-0022, USA.
authors.forename: Staci L
authors.initials: SL
authors.lastname: Sudenga
authors.forename: Mirjam-Colette
authors.initials: MC
authors.lastname: Kempf
authors.forename: Gerald
authors.initials: G
authors.lastname: McGwin
authors.forename: Craig M
authors.initials: CM
authors.lastname: Wilson
authors.forename: Edward W
authors.initials: EW
authors.lastname: Hook
authors.forename: Sadeep
authors.initials: S
authors.lastname: Shrestha
mesh_terms: D000293:Adolescent; D018791:CD4 Lymphocyte Count; D005260:Female; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000453:epidemiology* / Q000276:immunology; D015497:HIV-1 / Q000302:isolation & purification*; D006558:Herpes Genitalis / Q000453:epidemiology* / Q000276:immunology; D018258:Herpesvirus 2, Human / Q000302:isolation & purification*; D006801:Humans; D015994:Incidence; D008297:Male; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D019562:Viral Load