Effect of HSV-2 Serostatus on Acquisition of HIV by Young Men: Results of a Longitudinal Study in Orange Farm, South Africa

• Published in: The Journal of infectious diseases Vol. 199; no. 7; pp. 958 - 964
• Main Authors: Sobngwi-Tambekou, Joelle, Taljaard, Dirk, Lissouba, Pascale, Zarca, Kevin, Puren, Adrian, Lagarde, Emmanuel, Auvert, Bertran
• Format: Journal Article
• Language: English
• Published: Oxford The University of Chicago Press 01.04.2009; University of Chicago Press; Oxford University Press
• Subjects: Adolescent; AIDS; Antibodies, Viral - blood; Biological and medical sciences; Circumcision, Male; Experimentation; Fundamental and applied biological sciences. Psychology; Genitalia; Herpes Genitalis - complications; Herpes Genitalis - epidemiology; Herpes Genitalis - immunology; Herpes simplex virus 2; Herpesvirus 2, Human - immunology; HIV; HIV infections; HIV Infections - epidemiology; HIV Infections - etiology; HIV Infections - prevention & control; HIV-1; HIV/AIDS; Human herpesvirus 2; Human immunodeficiency virus 2; Humans; Incidence; Infections; Infectious diseases; Life Sciences; Longitudinal Studies; Male; Male circumcision; Medical sciences; Men; Microbiology; Miscellaneous; Protective effects; Risk Factors; Santé publique et épidémiologie; South Africa - epidemiology; Virology; Young Adult; South Africa; Africa; Virus; Human; Infection; Microbiology; Follow up study; Herpesviridae; Alphaherpesvirinae; Retroviridae; Human herpesvirus 2; Human immunodeficiency virus; Lentivirus
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/597208

BackgroundThe objectives of this study were to assess the impact among young men of herpes simplex virus type 2 (HSV-2) status on the acquisition of human immunodeficiency virus (HIV) and on the protective effect of male circumcision against HIV acquisition MethodsWe used data collected during a male circumcision trial conducted in Orange Farm, South Africa. We estimated adjusted incidence rate ratios (IRRs) for HIV acquisition, using survival analysis and background characteristics, HSV-2 status, male circumcision status, and sexual behavior as covariates ResultsCompared with subjects who remained HSV-2 negative throughout the study, subjects who were HSV-2 positive at enrollment had an adjusted IRR of 3.3 (95% confidence interval [CI], 1.5–7.4; P=.004), and those who became HSV-2 positive during follow-up had an adjusted IRR of 7.0 (95% CI, 3.9–12.4; P<.001). The population fraction of incident HIV infection attributable to HSV-2 was 27.8% (95% CI, 17.7%–37.2%). Intention-to-treat analysis of the protective effect of male circumcision on HIV acquisition was the same among men with and men without HSV-2 (0.38 vs. 0.37; P=.93) ConclusionsThis study shows that HSV-2 has a substantial impact on HIV acquisition among young South African men. It suggests that HSV-2 infection enhances HIV acquisition and is responsible for ∼25% of incident cases of HIV infection. However, the protective effect of male circumcision against HIV acquisition appears independent of HSV-2 serostatus Trial registrationClinicalTrials.gov identifier: NCT00122525