Recent Herpes Simplex Virus Type 2 Infection and the Risk of Human Immunodeficiency Virus Type 1 Acquisition in India

Abstract

To estimate the impact of prevalent and incident herpes simplex virus type 2 (HSV-2) infection on the acquisition of human immunodeficiency virus type 1 (HIV-1), stored serum samples from a cohort of 2732 HIV-1-seronegative patients attending 3 sexually transmitted infection clinics and 1 reproductive tract infection clinic in Pune, India, were screened for HSV-2-specific antibodies. Incident HSV-2 infection was defined serologically as "recent" if a negative result of testing for HSV-2 could be documented within the previous 6 months or "remote" if >6 months had elapsed since the last negative test result. The prevalence of HSV-2 at enrollment was 43%. The HSV-2 incidence was 11.4 cases/100 person-years, and the HIV-1 incidence was 5.8 cases/100 person-years. The adjusted hazard ratios of HIV-1 acquisition from exposure to HSV-2 infection were 1.67 for prevalent HSV-2, 1.92 for remote incident HSV-2, and 3.81 for recent incident HSV-2. Recent incident HSV-2 infection was associated with the highest risk of HIV-1 in this study, which suggests that prevention of HSV-2 infection may reduce the risk of HIV-1 acquisition.

Prevalence, Incidence and Risk Factors for Acquisition of Herpes Simplex Virus Type 2 among Fishermen on the Shores of Lake Victoria in Kisumu County, Kenya

“…Transactional sex as a risk for HSV-2 acquisition was also observed in other studies [10] [25]. Moreover, recent sex with casual partners, multiple sexual partners and inconsistent condom use; found to be independently associated with HSV-2 incidence in this study, were also demonstrated elsewhere [10] [13] [27] [30].…”

“…Similar high prevalence (43% -80%) was previously observed among fishermen along Lake Victoria in Kenya [23], among patients attending STD clinic in India [10], among women at high risk for HIV infection in Mozambique [27] and among female sex workers in Mombasa, Kenya [15] [24]. Risk factors for prevalent HSV-2 infection ( Table 2) found in this study (older age, marital status, inconsistent condom use, history of STI, and HIV infection) were consistent with results from other studies [10] [15] [23] [24].…”

“…The estimated baseline HSV-2 prevalence of 56% is over two times higher than the estimated HSV-2 prevalence of 26.3% for men drawn from the general national adult population in Kenya [25] [26], 26.5% among young men in Kisumu Kenya [16], 22% among high risk men for HIV in Mombasa, Kenya [15] and 20.3% among MSM in the US [13]. Similar high prevalence (43% -80%) was previously observed among fishermen along Lake Victoria in Kenya [23], among patients attending STD clinic in India [10], among women at high risk for HIV infection in Mozambique [27] and among female sex workers in Mombasa, Kenya [15] [24]. Risk factors for prevalent HSV-2 infection ( Table 2) found in this study (older age, marital status, inconsistent condom use, history of STI, and HIV infection) were consistent with results from other studies [10] [15] [23] [24].…”

“…Epidemiological studies have established a strong association between prevalent HSV-2 and incident HIV infection [7]- [14]. Recent studies further suggest that incident HSV-2 infection increases the risk for new HIV infection [10] [12] [14]- [16]. In summary, underlying HSV-2 infection substantially elevates the risk of incident HIV infection.…”

Seroprevalence and Influence of Torch Infections in High Risk Pregnant Women: A Large Study from South India

“…Highest prevalence of HSV has been found in Africa and America and the lowest in Western and Southern Europe, and in Asia [49][50][51]. The incidence of neonatal infection ranges from 1 in 2,500 to 1 in 20,000 live births and two-thirds of cases are caused by HSV-2 [52].…”