Seroprevalence and incidence of genital ulcer infections in a rural Ugandan population

Kamali, Anatoli; Nunn, Andrew; Mulder, Daan W.; Dyck, E Van; Dobbins, James G.; Whitworth, James

doi:10.1136/sti.75.2.98

Cited by 90 publications

(67 citation statements)

References 32 publications

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“…In our study, as in Haiti , Africa and Europe 16,26,19 , we found that women aged 20 and above had higher prevalent HSV-2 infection. This high prevalence in women is similar to studies in Uganda where prevalence was about 50%…”

supporting

confidence: 51%

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

Joloba¹,

Kambugu²,

Wasubire³

et al. 2015

Afr H. Sci.

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Background:Prevalence of herpes simplex type 2 virus (HSV-2) is high worldwide. Previous studies in Uganda were rural or in women. We estimated age and sex-specific sero-prevalence of HSV-2 in Kampala, Uganda. Methods: Using two-stage random sampling stratified on population density, a survey of persons 15-65 years was conducted. Type-specific serological tests for HSV-2, HSV-1(HerpeSelect2 and 1 ELISA), HIV (Rapid tests and ELISA), syphilis (RPR and TPHA) were done. Additional prevalence analysis included post-stratification weighting on the Uganda 2002 Census gender distribution. Results: Among 1124 persons, HSV-2 prevalence was 58% (95% CI: 55, 60), HSV-1; 98% (95% CI: 97.6, 99.1), HIV; 17.7% (95% CI: 14.8, 19.2) and syphilis; 1.7% (95% CI: 1.4, 1.9). Weighted HSV-2 prevalence was 53.8% (Women; 63.8%, men; 43.2%), similar to unweighted data. Weighted HIV prevalence was 20.7% in women, 8.6% in men. Of 165 HIV infected persons, 85.4% had HSV-2. Risk factors for HSV-2 were being a woman (OR 2.0; 95% CI: 1.42, 2.78), age (OR 3.3; 95% CI: 2.43, 4.53), education (OR 1.70; 95% CI: 1.34, 2.34) and HIV (OR 4.5; 95% CI: 2.70, 7.50). Conclusion: Prevalence of HSV-2 and HIV was high especially in women. Syphilis was rare. Awareness of herpes was low. Interventions in young people are needed.

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supporting

confidence: 51%

“…Prevalence of HSV-2 was higher than in earlier rural population studies in Uganda (Rakai, Masaka) 19,20 . The Uganda national sero-behavioral survey done in 2004-5 showed similar prevalence of HSV-2 21 with a different a serological test and low syphilis..…”

contrasting

confidence: 43%

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

Joloba¹,

Kambugu²,

Wasubire³

et al. 2015

Afr H. Sci.

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“…In rural populations in Africa sampled randomly, the prevalence of HSV-2 antibodies was 75% in women >25 years and 60% in men >30 years in Mwanza, Tanzania 40 and 68% overall in Masaka, Uganda. 41 High rates (59%) are also reported in commercial sex workers in Nigeria. 42 Among young men recruited into the armed forces in northern Thailand, the HSV-2 antibody prevalence was 41%.…”

Section: Hsv In Developing Countries: the Presentmentioning

confidence: 97%

“…61 However, in a later phase of the study the RR of HSV incidence was 3.7 in HIV positive cases versus HIV negative and HIV prevalence was strongly associated with HSV-2. 41 While this study did not examine the relation between HIV incidence and HSV-2 incidence, the population risk of HIV attributable to genital herpes is likely to be considerable given that recurrent episodes of genital ulceration are common.…”

Section: Hsv As a Risk Factor For Hivmentioning

confidence: 99%

Increasing prevalence of genital herpes in developing countries: implications for heterosexual HIV transmission and STI control programmes

O’Farrell

1999

Sexually Transmitted Infections

100

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Background:The recognition that sexually transmitted infections (STI) facilitate HIV transmission among heterosexuals has led to a rejuvenated focus on improving STI control as a component of HIV prevention programmes in developing countries. While eVorts so far have focused mainly on all STI, there is increasing evidence that genital ulcers facilitate a considerable proportion of HIV transmission among heterosexuals and that this eVect has been underestimated. This paper focuses on the epidemiology of genital herpes in developing countries past and present. Objectives: To review the scientific literature about the epidemiology of genital herpes in developing countries and discuss the implications of the findings for STI control and HIV prevention programmes. Search methodology: A Medline search for June 1966 to August 1999 using the keywords, genital herpes, STD and developing countries, and genital ulcers in MeSH and free text. Abstract books from recent international AIDS conferences and other international STD conferences were reviewed. The annual reports of the medical oYcers of heath for Harare 1982 and Durban 1989 were reviewed to detect trends in genital herpes diagnoses. Findings: Genital herpes, formerly regarded as a minor STI in most developing countries, has now emerged as a leading cause of genital ulceration in many countries where syphilis and chancroid were more prevalent previously. This increased recognition of genital herpes reflects both a change in the pattern of STI epidemiology through a decline in syphilis and chancroid as a response to HIV control programmes and improved techniques for diagnosing herpetic infection. Countries with significant heterosexual HIV epidemics also appear to have rapidly increasing numbers of genital herpes cases. Conclusions:The emergence of this herpes epidemic must be addressed through innovative strategies that will be viable, sustainable, acceptable, and eVective in developing countries. In countries where genital herpes is a significant problem, local adaptation of WHO treatment algorithms should be made. STI service providers should be trained about issues around the transmission of herpes and how best to advise clients about dealing with, and recognising, recurrences. The eVectiveness of antiviral treatment for genital herpes should be investigated in core groups at high risk of HIV. (Sex Transm Inf 1999;75:377-384)

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“…Approximately 17% of individuals in the United States (39) and up to 75% worldwide (13,25) are infected with HSV-2. HSV-2 infects primarily the genital epithelium, where foci of replication cause vesicles to form and ulcerate.…”

mentioning

confidence: 99%

Virus-Encoded B7-2 Costimulation Molecules Enhance the Protective Capacity of a Replication-Defective Herpes Simplex Virus Type 2 Vaccine in Immunocompetent Mice

Vagvala

Thebeau

Wilson

et al. 2009

J Virol

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Herpes simplex virus 2 (HSV-2) and, to a lesser extent, HSV-1 cause the majority of sexually transmitted genital ulcerative disease. No effective prophylactic vaccine is currently available. Replication-defective HSV stimulates immune responses in animals but produces no progeny virus, making it potentially useful as a safe form of live vaccine against HSV. Because it does not replicate and spread in the host, however, replicationdefective virus may have relatively limited capacity to solicit professional antigen presentation. We previously demonstrated that in mice devoid of B7-1 and B7-2 costimulation molecules, replication-defective HSV-2 encoding B7-1 or B7-2 induces stronger immune responses and protection against HSV-2 challenge than immunization with replication-defective virus alone. Here, we vaccinated wild-type mice fully competent to express endogenous B7 costimulation molecules with replication-defective HSV-2 or replication-defective virus encoding B7-2 and compared their capacities to protect against vaginal HSV-2 infection and disease. Replication-defective virus encoding B7-2 induced more IFN-␥-producing CD4 T cells than did replication-defective virus alone. Immunization with B7-2-expressing virus decreased challenge virus replication in the vaginal mucosa, genital and neurological disease, and mortality more effectively than did immunization with the parental replication-defective virus. Prior immunization with B7-expressing, replication-defective virus also effectively suppressed infection of the nervous system compared to immunization with the parental virus. Thus, B7 costimulation molecules expressed at the site of HSV infection can enhance vaccine efficacy even in a fully immunocompetent host.

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Seroprevalence and incidence of genital ulcer infections in a rural Ugandan population

Cited by 90 publications

References 32 publications

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

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

Increasing prevalence of genital herpes in developing countries: implications for heterosexual HIV transmission and STI control programmes

Virus-Encoded B7-2 Costimulation Molecules Enhance the Protective Capacity of a Replication-Defective Herpes Simplex Virus Type 2 Vaccine in Immunocompetent Mice

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