title: Incident HSV-2 infections are common among HIV-1-discordant couples.
abstract: BACKGROUND
  The synergy between herpes simplex virus type 2 (HSV-2) and human immunodeficiency virus type 1 (HIV-1) is well known, but lack of knowledge about the epidemiology of HSV-2 acquisition in HIV-1-discordant couples hampers development of HSV-2 prevention interventions that could reduce HIV-1 transmission.
  
  
  METHODS
  HIV-1-discordant couples were enrolled in Nairobi, Kenya, and followed for up to 2 years. HSV-2 status was determined using HerpeSelect HSV-2 ELISA. Correlates of prevalence and incidence were assessed. RESULTS.: Of 469 HIV-1-discordant couples, at baseline, 353 (75.3%) were affected by HSV-2, of which 189 (53.5%) were concordantly HSV-2 seropositive and 164 (46.5%) were HSV-2-discordant. Prevalence was lowest among HIV-1-uninfected men (39.9%) compared to HIV-1-infected women (64.8%), HIV-1-infected men (66.7%), and HIV-1-uninfected women (68.5%). During follow-up, HSV-2 seroincidence was 14.9 per 100 person-years. Incidence was 1.6-fold higher among females compared to males (95% confidence interval [CI], 1.00-2.48) and 2.5-fold higher in HIV-1-infected compared to uninfected women (95% CI, 1.12-5.74). At least 30% of incident HSV-2 infections originated from an outside partner.
  
  
  CONCLUSIONS
  The high HSV-2 prevalence and incidence in HIV-1-discordant couples in sub-Saharan Africa suggest HSV-2 treatment and prevention could be an effective targeted strategy to reduce HSV-2 and HIV-1 transmission in this high-risk population.
authors.affiliation: Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Anthony N
authors.initials: AN
authors.lastname: Muiru
authors.forename: Brandon L
authors.initials: BL
authors.lastname: Guthrie
authors.forename: Rose
authors.initials: R
authors.lastname: Bosire
authors.forename: Michele
authors.initials: M
authors.lastname: Merkel
authors.forename: Amy Y
authors.initials: AY
authors.lastname: Liu
authors.forename: Robert Y
authors.initials: RY
authors.lastname: Choi
authors.forename: Barbara
authors.initials: B
authors.lastname: Lohman-Payne
authors.forename: Ann
authors.initials: A
authors.lastname: Gatuguta
authors.forename: Romel D
authors.initials: RD
authors.lastname: Mackelprang
authors.forename: James N
authors.initials: JN
authors.lastname: Kiarie
authors.forename: Carey
authors.initials: C
authors.lastname: Farquhar
mesh_terms: D000328:Adult; D004797:Enzyme-Linked Immunosorbent Assay; D005191:Family Characteristics; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000821:virology; D015497:HIV-1 / Q000302:isolation & purification*; D006558:Herpes Genitalis / Q000453:epidemiology* / Q000821:virology; D018258:Herpesvirus 2, Human / Q000302:isolation & purification*; D006801:Humans; D015994:Incidence; D007630:Kenya / Q000453:epidemiology; D008297:Male; D015995:Prevalence
keywords: Africa; ELISA; HIV; HSV-2; Kenya; antiviral; couples; discordant; genital ulcer disease; herpes; incidence; prevalence; prevention; seroconvert; serodiscordant; transmission