title: Herpes Simplex Virus Type-2 Cervicovaginal Shedding Among Women Living With HIV-1 and Receiving Antiretroviral Therapy in Burkina Faso: An 8-Year Longitudinal Study.
abstract: BACKGROUND
  The impact of antiretroviral therapy (ART) on herpes simplex virus type-2 (HSV-2) replication is unclear. The aim of this study was to assess factors associated with cervicovaginal HSV-2 DNA shedding and genital ulcer disease (GUD) in a cohort of women living with human immunodeficiency virus type-1 (HIV-1) in Burkina Faso.
  
  
  METHODS
  Participants were screened for cervicovaginal HSV-2 DNA, GUD, cervicovaginal and systemic HIV-1 RNA, and reproductive tract infections every 3-6 months over 8 years. Associations with HSV-2 shedding and quantity were examined using random-effects logistic and linear regression, respectively.
  
  
  RESULTS
  Of the 236 women with data on HSV-2 shedding, 151 took ART during the study period. Cervicovaginal HSV-2 DNA was detected in 42% of women (99 of 236) in 8.2% of visits (151 of 1848). ART was associated with a reduction in the odds of HSV-2 shedding, which declined for each year of ART use (odds ratio [OR], 0.74; 95% confidence interval [CI], .59-.92). In the multivariable model, the impact of ART was primarily associated with suppression of systemic HIV-1 RNA (adjusted OR, 0.32; 95% CI, .15-.67). A reduction in the odds of GUD was also observed during ART, mainly in those with HIV-1 suppression (adjusted OR, 0.53; 95% CI, .25-1.11).
  
  
  CONCLUSIONS
  ART is strongly associated with a decrease in cervicovaginal HSV-2 shedding, and the impact was sustained over several years.
authors.affiliation: London School of Hygiene and Tropical Medicine, United Kingdom.
authors.forename: Andrea J
authors.initials: AJ
authors.lastname: Low
authors.affiliation: UMR 1058 University of Montpellier Montpellier University Hospital, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Nagot
authors.affiliation: London School of Hygiene and Tropical Medicine, United Kingdom.
authors.forename: Helen A
authors.initials: HA
authors.lastname: Weiss
authors.affiliation: Centre Muraz, Bobo-Dioulasso, Burkina Faso.
authors.forename: Issouf
authors.initials: I
authors.lastname: Konate
authors.affiliation: Centre Muraz, Bobo-Dioulasso, Burkina Faso.
authors.forename: Dramane
authors.initials: D
authors.lastname: Kania
authors.affiliation: UMR 1058 University of Montpellier Montpellier University Hospital, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Segondy
authors.affiliation: Centre Muraz, Bobo-Dioulasso, Burkina Faso.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Meda
authors.affiliation: UMR 1058 University of Montpellier Montpellier University Hospital, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: van de Perre
authors.affiliation: London School of Hygiene and Tropical Medicine, United Kingdom.
authors.forename: Philippe
authors.initials: P
authors.lastname: Mayaud
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D002050:Burkina Faso / Q000453:epidemiology; D004279:DNA, Viral / Q000302:isolation & purification; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D006558:Herpes Genitalis / Q000150:complications* / Q000453:epidemiology / Q000821:virology*; D018258:Herpesvirus 2, Human / Q000502:physiology*; D006801:Humans; D016014:Linear Models; D016017:Odds Ratio; D017201:Virus Shedding / Q000502:physiology*; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents; D004279:DNA, Viral
keywords: Burkina Faso; HIV-1; HSV-2; antiretrovirals; female; genital tract; genital ulcer disease; herpes simplex virus type-2