Effect of Herpes Simplex Suppression on Incidence of HIV among Women in Tanzania

Watson-Jones, Deborah; Weiss, Helen A.; Rusizoka, Mary; Changalucha, John; Baisley, Kathy; Mugeye, Kokugonza; Tanton, Clare; Ross, David A.; Everett, Dean; Clayton, Tim; Balira, Rebecca; Knight, Louise; Hambleton, Ian; Goff, Jérôme Le; Bélec, Laurent; Hayes, Richard

doi:10.1056/nejmoa0800260

Cited by 332 publications

(270 citation statements)

References 29 publications

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“…Early exposure to sexual intercourse has therefore been linked to increased risk of sexually transmitted infections (STIs) during adolescence [30,31]. The increased STI risk is due, in part, to a biologic predisposition of the immature cervix to infection if exposed [32] and to the increased likelihood of engaging in riskier sexual behaviors among persons who initiate sexual intercourse at younger ages [31,34].…”

Section: Discussionmentioning

confidence: 99%

Sexual behavioral correlates with HSV-2 seroprevalence among pregnant women in Nigeria

Kalu

Ojide

Fowotade

et al. 2014

J Infect Dev Ctries

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Introduction: The burden of HSV-2 infection, the cause of most cases of genital herpes in Nigeria, varies from region to region; and so are the associated factors. This infection is known to be responsible for several negative pregnancy outcomes. There is currently no documented data on sexual behavioral factors associated with the occurrence of HSV-2 infection or seroprevalence among pregnant women in Nigeria. This study aimed at identifying the sexual behavioral correlates of HSV-2 seroprevalence among pregnant women in Benin City, Nigeria. Methodology: The cross-sectional study design was adopted and the study took place between November 2011 and June 2012. Four hundred and ten consenting ante-natal clinic patients in two major tertiary hospitals in Benin City were consecutively and prospectively included. Data sources were represented by questionnaires, the patient's case records and laboratory investigations. Each patient's serum was analyzed for HSV-2 antibody detection. Data analysis was performed using SPSS version 16. Results: Four hundred and ten patients were enrolled with average age 30.6 years. Seroprevalence of HSV-2 antibody was 47.3%. Sexual behavioral factors that were significantly associated with HSV-2 seroprevalence included early exposure to sexual intercourse, number of sex partners, involvement in polygamous marriages, involvement of husband in extra-marital affairs and hormonal contraceptive use. Conclusion: The prevalence of HSV-2 among pregnant women in Benin City is high. Public health campaigns aimed at: delaying onset of sexual activity; encouraging monogamous relationships; and emphasizing that hormonal contraceptives do not protect from STI's, are recommended.

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Section: Discussionmentioning

confidence: 99%

Sexual behavioral correlates with HSV-2 seroprevalence among pregnant women in Nigeria

Kalu

Ojide

Fowotade

et al. 2014

J Infect Dev Ctries

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“…Numerous published studies have reported that HSV-2 increases acquisition and transmission of HIV infection while HIV increases susceptibility to and shedding of HSV-2 infection [31,32]. However, Watson-Jones et al reported a lack of effect of HSV-2 suppressive therapy (using acyclovir 400mg twice daily) on HIV acquisition [33]. The World Health Organization recommends the use of an antiviral treatment for herpes in high HSV-2 prevalent areas [34].…”

Section: Discussionmentioning

confidence: 99%

Aetiology of sexually transmitted infections in Maputo, Mozambique

Zimba

Apalata

Sturm

et al. 2010

J Infect Dev Ctries

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Introduction: The study sought to ascertain the prevalence of the aetiological agents of genital discharge and genital ulcer diseases in Maputo, Mozambique. Methodology: Consecutive consenting patients presenting to the Centro de Saúde do Porto in Maputo between March and April 2005 with genital discharge syndrome and/or genital ulcer diseases were recruited. Specimens were collected for the identification of STI pathogens. Results: Of 346 recruited patients, 164 were male and 182 female. The prevalence of confirmed single aetiological agents for male urethritis was as follows: N. gonorrhoeae, 35%; C. trachomatis, 10%; and M. genitalium 4%. For vaginal discharge, N. gonorrhoeae was found in11% of the women tested, followed by C. trachomatis (6.5%), bacterial vaginosis (34%), and T. vaginalis (2%). The prevalence of genital ulcers was as follows: Herpes simplex virus type 2, 62%; H. ducreyi 4 %; and C. trachomatis biovar LGV, 4%. Five percent of patients with genital ulcers had a positive syphilis serology (RPR ≥ 1:8 and confirmed by TPHA) and 35% of all tested patients were HIV-1/2 infected. Cases of mixed infections were present in 5%, 11% and 3% of patients with male urethritis, vaginal discharge, and genital ulcers respectively. Conclusion: The classic sexually transmitted infection aetiologies are still prevalent in Maputo. The study highlights the need for a periodic surveillance to inform syndromic management protocols.

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“…Implications of genital herpes infection include the risk of transmission to sexual partners and offspring as well as an increased risk of acquiring and transmitting HIV. Epidemiological studies consistently demonstrate that mucosal HIV-1 shedding is more frequent and in greater amounts during mucosal and subclinical reactivations (Corey et al, 2004;Nagot et al, 2007;Watson-Jones et al, 2008). HSV-2 can be detected in swabs obtained from the cervix from seropositive subjects by culture on 3% of days and by sensitive DNA PCR on about 20% of days, illustrating the high frequency of asymptomatic shedding (Wald et al, 2000).…”

Section: The Cotton Rat Model Of Hsv Infectionmentioning

confidence: 94%