Prevalence, incidence and correlates of HSV-2 infection in an HIV incidence adolescent and adult cohort study in western Kenya

Abstract

BackgroundHerpes simplex virus type 2 (HSV-2) infections are associated with increased risk of HIV transmission. We determined HSV-2 prevalence, incidence and associated risk factors, incidence among persons with indeterminate results, and prevalence of HSV-2/HIV co-infection among young adults (18–34 years) and adolescents (16–17 years) enrolled in an HIV incidence cohort study in western Kenya.MethodsParticipants (n = 1106; 846 adults) were screened and those HIV-1 negative were enrolled and followed-up quarterly for one year. HSV-2 was assessed using the Kalon enzyme immunoassay. HSV-2 incidence was calculated separately among HSV-2 seronegative participants and those indeterminate at baseline. Logistic regression was used to estimate the odds of HSV-2 infection and Poisson regression was used to assess HSV-2 incidence and associated factors.ResultsOverall, HSV-2 prevalence was 26.6% [95% confidence interval (CI): 23.9–29.4] and was higher in adults (31.5% [95% CI: 28.3–34.9]) than adolescents (10.7% [95% CI: 7.1–15.3]). Factors associated with prevalent HSV-2 included female gender, increasing age, HIV infection, history of sexually transmitted infection, low level of education, multiple sexual partners, and being married, divorced, separated or widowed. Overall HSV-2 incidence was 4.0 per 100 person-years (/100PY) 95% CI: 2.7–6.1 and was higher in adults (4.5/100PY) and females (5.1/100PY). In multivariable analysis only marital status was associated with HSV-2 incidence. Among 45 participants with indeterminate HSV-2 results at baseline, 22 seroconverted, resulting in an incidence rate of 53.2 /100PY [95% CI: 35.1–80.9]. Inclusion of indeterminate results almost doubled the overall incidence rate to 7.8 /100 PY [95% CI: 5.9–10.5]. Prevalence of HIV/HSV-2 co-infection was higher in female adults than female adolescents (17.1 [95% CI: 13.6–21.0] versus 3.4 [95% CI: 1.1–7.8]).ConclusionThe high incidence rate among persons with indeterminate results underscores the public health concerns for HSV-2 spread and underreporting of the HSV-2 burden. Careful consideration is needed when interpreting HSV-2 serology results in these settings.

Two-Way Short Message Service (SMS) Communication May Increase Pre-Exposure Prophylaxis Continuation and Adherence Among Pregnant and Postpartum Women in Kenya

“…The PrEP Implementation for Young Women and Adolescents (PrIYA) Program was a 2-year implementation project in Kusumu County, Kenya, a region where adult HIV prevalence is 19.9% (up to 28% among pregnant women). [22][23][24] The program was designed to reach adolescents and young women at high risk for HIV acquisition through integrated delivery of PrEP within routine MCH and family planning systems. 9 Conducted in collaboration with the Kisumu County Department of Health and Sanitation and the National AIDS and STI Control Programme, PrIYA was first implemented in 16 facilities (11 public, 4 faithbased, and 1 private) followed by a PrEP mentorship program in 20 additional sites.…”

Extracellular vesicles: novel vehicles in herpesvirus infection

“…HSV-2 is also involved in HIV infection and prevalence, and the ability of HSV-2 to evade the immune response and establish a latent infection has made it difficult to develop an effective vaccine (Chan et al, 2011). The innate and adaptive immune processes underlying the response to HSV-2 provide a powerful foundation for the research and development of an effective HSV-2 vaccine (Akinyi et al, 2017;Zhu et al, 2017). However, to date, there has not been a study on the relationship between HSV-2 infection and exosomes.…”

Natural Products-Derived Chemicals: Breaking Barriers to Novel Anti-HSV Drug Development

“…Moreover, infection with HSV-2 can cause recurrent, painful genital lesions and is often connected with negative psychosocial consequences such as shame, anxiety, and depression. Furthermore, infection with HSV-2 was observed to be a high-risk factor for potential HIV infection, as well as invasive cervical carcinoma [6]. Several reports have declared that HSV is involved in various ocular diseases, including stromal keratitis, endotheliitis and neurotrophic keratopathy [4][5][6][7].…”

“…Furthermore, infection with HSV-2 was observed to be a high-risk factor for potential HIV infection, as well as invasive cervical carcinoma [6]. Several reports have declared that HSV is involved in various ocular diseases, including stromal keratitis, endotheliitis and neurotrophic keratopathy [4][5][6][7]. The current existant treatment of HSV infection relies mainly on the use of acyclovir (ACV) and related synthetic nucleoside analogs.…”