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




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Background

Herpes 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.

Methods

Participants 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.

Results

Overall, 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.

Conclusion

The 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.



Autor: Brenda Akinyi, Collins Odhiambo, Fredrick Otieno, Seth Inzaule, Simon Oswago, Emily Kerubo, Richard Ndivo, Clement Zeh

Fuente: http://plos.srce.hr/



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