Sexually transmitted bedfellows: exquisite association between HIV and HSV2 in 21 communities in Southern Africa in the HPTN 071 (PopART) study
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Background: HIV and Herpes simplex virus type-2 (HSV2) are strongly associated, although mechanisms are not fully understood. An HIV prevention trial allowed re-examination of this association at individual and community levels. Methods: HPTN 071 (PopART) evaluates a combination prevention intervention in 21 urban communities in Zambia and South Africa. To measure impact on HIV incidence, a cohort of ~2,000 adults (18-44y) was selected randomly from each community. Baseline data on socio-demographic characteristics, behaviour and HIV/HSV2 serology were used to examine the association between HIV and HSV2. At community-level, HIV prevalence was plotted against HSV2 prevalence. Results: 38,691 adults participated. HSV2 prevalence in women/men was 50%/22% (Zambia) and 60%/27% (South Africa). Estimated HSV2 incidence in those aged 18-24y was 8.06 (95%:CI:6.76-9.35) and 1.76 (95%CI:1.30-2.22) per 100/py in women and men, respectively. Six-fold higher odds of HIV were seen in HSV2-infected individuals in both sexes, after adjustment for confounders (Women:OR:6.66,95%CI: 6.07-7.31;Men:OR:6.57,95%CI:5.56-7.77). At community-level there was a strong linear relationship between HIV and HSV2 prevalence (ρ = 0.92,p<0.001). Conclusions: There was an exquisite association between these two infections, at individual and community levels, likely due partly to a powerful cofactor effect of HSV2 on HIV transmission. HSV2 control could contribute to HIV prevention.
Date Issued
2018-08-01
Date Acceptance
2018-04-05
Citation
Journal of Infectious Diseases, 2018, 218 (3), pp.443-452
ISSN
0022-1899
Publisher
Oxford University Press (OUP)
Start Page
443
End Page
452
Journal / Book Title
Journal of Infectious Diseases
Volume
218
Issue
3
Copyright Statement
© 2018 The Author(s). Published by Oxford University Press for the Infectious Diseases Society of America.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/29659909
PII: 4962568
Subjects
HPTN 071 (PopART) Study Team
11 Medical And Health Sciences
06 Biological Sciences
Microbiology
Publication Status
Published
Coverage Spatial
United States
Date Publish Online
2018-04-06