Sero-prevalence of herpes simplex type 2 virus (HSV-2) and HIV infection in Kampala, Uganda

Joloba, Moses; Kambugu, Fred; Wasubire, Julius; Kimeze, Joshua; Salata, Robert A.; Albert, Jeffrey M.; Rimm, Alfred A.; Whalen, Christopher C.

doi:10.4314/ahs.v14i4.2

Cited by 20 publications

(16 citation statements)

References 40 publications

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“…After a longer period of follow-up, the incidence of HSV-2 seroconversion increases, as evidenced by the Zimbabwe study where, after a follow-up period up to nine months after delivery, the incidence increased from 4.2% to 12% [5]. The higher incidence of HSV-2 over a shorter follow-up in Uganda may be explained by the fact that the population level of HSV-2 is generally high, leading to higher rates of contact between infected and uninfected persons [6,22,26]. The seroprevalence of HSV-2 among women in Kampala was above 60% [6,22].…”

Section: Discussionmentioning

confidence: 92%

“…The higher incidence of HSV-2 over a shorter follow-up in Uganda may be explained by the fact that the population level of HSV-2 is generally high, leading to higher rates of contact between infected and uninfected persons [6,22,26]. The seroprevalence of HSV-2 among women in Kampala was above 60% [6,22]. However, in Italy, where the HSV-2 seroprevalence among pregnant women was only an eighth of the seroprevalence in Uganda, the incidence of HSV-2 seroconversion during pregnancy was also low (3%) [1].…”

Section: Discussionmentioning

confidence: 99%

“…For detection of seroconversion, taking the cut-off of 1.1 and above as positive had low specificity (less than 70%) [21]. The cut-off optical density of 3.5 and above was therefore considered to be positive for seroconversion and below that to be negative, similar to what has been the recent practice in African studies [20,22].…”

Section: Data Collectionmentioning

confidence: 99%

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Incidence and risk factors for herpes simplex virus type 2 seroconversion among pregnant women in Uganda: A prospective study

Nakubulwa

Kaye

Bwanga

et al. 2016

J Infect Dev Ctries

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Introduction: Herpes simplex virus type 2 (HSV-2) acquired during pregnancy is associated with adverse outcomes such as perinatal HSV-2 transmission. HSV-2 seroconversion occurs within four weeks of HSV-2 acquisition. There was neither documented incidence nor risk factors for HSV-2 seroconversion during pregnancy in Uganda. The objective of this study was to determine the incidence and risk factors for HSV-2 seroconversion among pregnant women in Mulago Hospital, Uganda. Methodology: A prospective study of 200 consenting HSV-2-negative women between 26 and 28 weeks of gestation was done between November 2013 and October 2014. HSV-2 serostatus was determined using HerpeSelect HSV-2 enzyme-linked immunosorbent assay (ELISA). Interviewer-administered questionnaires were used to collect socio-demographic characteristics and sexual history. Human immunodeficiency virus (HIV) serostatus was obtained from antenatal records. A total of 191 women completed follow-up and repeat HSV-2 serology by 38 weeks. Negative binomial regression analysis was used to estimate risk ratios for risk factors for HSV-2 seroconversion. Results: Of 191 women, 15 (7.9%) seroconverted during pregnancy. Having multiple sexual partners, being in polygamous unions, and having HIV-positive serostatus were found to be risk factors for HSV-2 seroconversion. Conclusions: The incidence of HSV-2 seroconversion during pregnancy in Uganda was high. Multiple sexual partners, polygamy, and HIVpositive serostatus were risk factors for HSV-2 seroconversion during pregnancy. Strengthening health education on the avoidance of multiple sexual partners during pregnancy is paramount in prevention of HSV-2 seroconversion.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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Incidence and risk factors for herpes simplex virus type 2 seroconversion among pregnant women in Uganda: A prospective study

Nakubulwa

Kaye

Bwanga

et al. 2016

J Infect Dev Ctries

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“…Herpes simplex virus-2 (HSV-2) is one of the most prevalent viral sexually transmitted infections (STIs) globally, with rates as high as 78% in women [1, 2]. According to the World Health Organization (WHO), 536 million people aged 15–49 are infected with HSV-2, the causative agent of genital herpes [3].…”

Section: Introductionmentioning

confidence: 99%

Prevalent Herpes Simplex Virus-2 Increases the Risk of Incident Bacterial Vaginosis in Women from South Africa

et al. 2017

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Studies have shown that women diagnosed with herpes simplex virus-2 (HSV-2) have a higher risk for bacterial vaginosis (BV) infection. We investigated the presence of HSV-2 infections as a risk factor for incident BV infections in high risk, Human immunodeficiency virus (HIV) uninfected women enrolled in a HIV prevention trial in Durban, South Africa. The Vaginal and Oral Interventions to Control the Epidemic trial was a multicentre, double blinded, randomized controlled trial which was designed to estimate the effectiveness of daily treatment with vaginal tenofovir gel, oral tenofovir disoproxil fumarate and oral Truvada in preventing HIV-1 infection in women. Women provided samples for the diagnosis of HSV-2 and BV. The presence of HSV-2 antibodies was detected using HerpeSelect™ ELISA IgG. Bacterial vaginosis was diagnosed using the Nugent scoring system. To assess the risk of BV incidence, modelled as a time-dependent variable, we used the Andersen-Gill model with robust variance estimation and Efron methods for ties. Overall, 2750 women were enrolled in the VOICE trial at our study sites. Women who had a HSV-2 infection at enrolment were shown to be at increased risk for incident BV infections (adjusted hazard ratio 1.17, 95% CI 1.08, 1.27, p ≤ 0.001). In addition, being of a young age, being unmarried and having a partner that has other partners were significantly associated with subsequent BV infection. Our findings therefore advocate the need for strengthening STI prevention efforts among women in high burden STI settings.

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“…The guidance to provide prompt HIV treatment to key populations, as a part of HIV prevention interventions in Uganda, stems from growing evidence of high HIV prevalence among groups of people engaged in risky sexual behaviour, including female sex workers. In Kampala, recent research has noted high HIV prevalence among women in the general population (Nakku-Joloba et al, 2015), and specifically among women engaged in sex work and their clients (Lindan et al, 2015;Vandepitte et al, 2011). Female sex workers are vulnerable to infection because many have multiple concurrent partners, may not always be able to negotiate condom use, and may also be at risk of violence from clients and regular partners, among other factors (Rutakumwa, Mbonye, Kiwanuka, Bagiire, & Seeley, 2015;Schulkind, Mbonye, Watts, & Seeley, in press;Scorgie et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Test and treat: the early experiences in a clinic serving women at high risk of HIV infection in Kampala

et al. 2016

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At the end of 2013, the Government of Uganda issued guidance recommending provision of AntiRetroviral Treatment (ART) to HIV-positive people in key populations, including female sex workers, regardless of CD4 cell count. We describe the implementation of this new guidance in a clinic serving women at high risk of HIV infection in Kampala. Between July and December 2015, we conducted repeat in-depth interviews with 15 women attending the clinic after the change in guidelines, to explore their perceptions regarding prompt ART initiation. The sample included some women who were HIV-negative and women who had both started and deferred ART. We conducted a data-led thematic analysis of the material from the interviews. A total of 257 of 445 eligible women had started ART; others were undecided or had not returned to the clinic after receiving the new information. Participants recounted varying experiences with the provision of prompt treatment. At an individual level, a history of treatment for opportunistic infections and other illnesses, coupled with relatively poor health, encouraged some to initiate ART promptly. However, knowledge of friends/relatives already on ART who had experienced side effects caused others to delay starting, fearing the same experience for themselves. A number of women questioned why they should start treatment when they were not sick. Situational factors such as work and residence (with many sharing single rooms) caused discomfort among newly diagnosed women who feared disclosure and stigma that would result from taking ART when they were not ill. Alcohol consumption and irregular working hours affected perceptions of future adherence, making prompt ART harder to embrace for some. Our findings show the challenges that influence the delay of treatment initiation, and/or the decision to defer receiving information on ART, with implications for the success of the test and treat programmes and guidelines.ARTICLE HISTORY

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Sero-prevalence of herpes simplex type 2 virus (HSV-2) and HIV infection in Kampala, Uganda

Cited by 20 publications

References 40 publications

Incidence and risk factors for herpes simplex virus type 2 seroconversion among pregnant women in Uganda: A prospective study

Incidence and risk factors for herpes simplex virus type 2 seroconversion among pregnant women in Uganda: A prospective study

Prevalent Herpes Simplex Virus-2 Increases the Risk of Incident Bacterial Vaginosis in Women from South Africa

Test and treat: the early experiences in a clinic serving women at high risk of HIV infection in Kampala

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