title: Risk factors for incident HSV-2 infections among a prospective cohort of HIV-1-discordant couples in China.
abstract: OBJECTIVE
  Identification of risk factors is essential for developing herpes simplex virus type 2 (HSV-2) prevention interventions that could also reduce HIV-1 transmission, particularly among HIV-1-discordant couples.
  
  
  METHODS
  A prospective cohort study was conducted among HIV-1-discordant couples from June 2009 to March 2011 in Yunnan province, China. 413 HIV-1-infected partners and 517 HIV-1-uninfected partners who were HSV-2 seronegative or equivocal at enrolment and who had a study partner completing the baseline survey and HSV-2 testing were included in the analysis.
  
  
  RESULTS
  HSV-2 incidence was 2.9 per 100 person-years (PY) for HIV-1-infected partners and 4.5 per 100 PY for HIV-1-uninfected partners. At least 36% of incident HSV-2 infections were from outside sexual partner. Among HIV-1-infected partners, multivariate analysis indicated that HSV-2 incidence was significantly higher among those with baseline equivocal HSV-2 result, having an initially HSV-2 seropositive or equivocal partner, reporting no sex with study partner and initiating antiretroviral therapy (ART) during follow-up. Among HIV-1-uninfected partners, multivariate analysis indicated that HSV-2 incidence was significantly higher among those having an initially HSV-2 seropositive partner and reporting sex with study partner ≥5 times/month, but was lower among those having a partner with baseline CD4(+) count ≥350 cells/μL.
  
  
  CONCLUSIONS
  Our findings underscore the importance of developing prevention and intervention programmes to reduce HSV-2 transmission among this population. The relationship between ART initiation and HSV-2 seroconversion requires further investigation.
authors.affiliation: Department of Epidemiology, School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China.
authors.forename: Yingying
authors.initials: Y
authors.lastname: Ding
authors.affiliation: National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, China.
authors.forename: Zunyou
authors.initials: Z
authors.lastname: Wu
authors.affiliation: Dehong Prefecture Center for Disease Control and Prevention, Mangshi, Yunnan Province, China.
authors.forename: Song
authors.initials: S
authors.lastname: Duan
authors.affiliation: National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, China.
authors.forename: Keming
authors.initials: K
authors.lastname: Rou
authors.affiliation: Dehong Prefecture Center for Disease Control and Prevention, Mangshi, Yunnan Province, China.
authors.forename: Yuecheng
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Dehong Prefecture Center for Disease Control and Prevention, Mangshi, Yunnan Province, China.
authors.forename: Jibao
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Epidemiology, School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China.
authors.forename: Meiyang
authors.initials: M
authors.lastname: Gao
authors.affiliation: Dehong Prefecture Center for Disease Control and Prevention, Mangshi, Yunnan Province, China.
authors.forename: Runhua
authors.initials: R
authors.lastname: Ye
authors.affiliation: Department of Epidemiology, School of Public Health, University of California, Los Angeles, Los Angeles, USA.
authors.forename: Roger
authors.initials: R
authors.lastname: Detels
authors.affiliation: Department of Epidemiology, School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China.
authors.forename: Na
authors.initials: N
authors.lastname: He
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D002681:China / Q000453:epidemiology; D005191:Family Characteristics; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology / Q000276:immunology*; D015497:HIV-1; D006558:Herpes Genitalis / Q000453:epidemiology / Q000276:immunology*; D018258:Herpesvirus 2, Human / Q000472:pathogenicity*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D012747:Sexual Partners
keywords: CD4; EPIDEMIOLOGY (GENERAL); HIV; HSV