Effect of HSV-2 Serostatus on Acquisition of HIV by Young Men: Results of a Longitudinal Study in Orange Farm, South Africa
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 mal...
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| Published in | The Journal of infectious diseases Vol. 199; no. 7; pp. 958 - 964 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Oxford
The University of Chicago Press
01.04.2009
University of Chicago Press Oxford University Press |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0022-1899 1537-6613 |
| DOI | 10.1086/597208 |
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| Abstract | 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 |
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| AbstractList | The 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. Methods. We 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. Results. Compared 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), and those who became HSV-2 positive during follow-up had an adjusted IRR of 7.0 (95% CI, 3.9-12.4). 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). Conclusions. This 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 [image]25% of incident cases of HIV infection. However, the protective effect of male circumcision against HIV acquisition appears independent of HSV-2 serostatus. Trial registration. ClinicalTrials.gov identifier: The 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. We 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. Compared 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). This 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 approximately 25% of incident cases of HIV infection. However, the protective effect of male circumcision against HIV acquisition appears independent of HSV-2 serostatus. ClinicalTrials.gov identifier: NCT00122525. 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 Background. The 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. Methods. We 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. Results. Compared 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). Conclusions. This 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 registration. ClinicalTrials. gov identifier: NCT00122525. BACKGROUND: The 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. METHODS: We 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. RESULTS: Compared 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). CONCLUSIONS: This 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 approximately 25% of incident cases of HIV infection. However, the protective effect of male circumcision against HIV acquisition appears independent of HSV-2 serostatus. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT00122525. 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 The 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.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.We 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.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.Compared 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).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).This 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 approximately 25% of incident cases of HIV infection. However, the protective effect of male circumcision against HIV acquisition appears independent of HSV-2 serostatus.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 approximately 25% of incident cases of HIV infection. However, the protective effect of male circumcision against HIV acquisition appears independent of HSV-2 serostatus.ClinicalTrials.gov identifier: NCT00122525.TRIAL REGISTRATIONClinicalTrials.gov identifier: NCT00122525. |
| Author | Taljaard, Dirk Sobngwi-Tambekou, Joelle Zarca, Kevin Auvert, Bertran Puren, Adrian Lissouba, Pascale Lagarde, Emmanuel |
| AuthorAffiliation | 3 National Institute for Communicable Disease National Institute for Communicable Disease Johannesburg,ZA 6 Hôpital Ambroise Paré AP-HP Hôpital Ambroise Paré Boulogne Billancourt, F-92100,FR 2 Progressus Progressus Johannesburg,ZA 4 Epidémiologie, santé publique et développement INSERM : U593 IFR99 Université Victor Segalen - Bordeaux II ISPED Universite Victor Segalen 146, Rue Leo Saignat 33076 BORDEAUX CEDEX,FR 5 UFR médicale Université de Versailles-Saint Quentin en Yvelines Garches, F-92340,FR 1 Santé publique et épidémiologie des déterminants professionnels et sociaux de la santé INSERM : U687 IFR69 Université Paris Sud - Paris XI Université de Versailles-Saint Quentin en Yvelines Hôpital Paul Brousse 16, av Paul Vaillant Couturier 94807 VILLEJUIF,FR |
| AuthorAffiliation_xml | – name: 3 National Institute for Communicable Disease National Institute for Communicable Disease Johannesburg,ZA – name: 2 Progressus Progressus Johannesburg,ZA – name: 4 Epidémiologie, santé publique et développement INSERM : U593 IFR99 Université Victor Segalen - Bordeaux II ISPED Universite Victor Segalen 146, Rue Leo Saignat 33076 BORDEAUX CEDEX,FR – name: 5 UFR médicale Université de Versailles-Saint Quentin en Yvelines Garches, F-92340,FR – name: 1 Santé publique et épidémiologie des déterminants professionnels et sociaux de la santé INSERM : U687 IFR69 Université Paris Sud - Paris XI Université de Versailles-Saint Quentin en Yvelines Hôpital Paul Brousse 16, av Paul Vaillant Couturier 94807 VILLEJUIF,FR – name: 6 Hôpital Ambroise Paré AP-HP Hôpital Ambroise Paré Boulogne Billancourt, F-92100,FR |
| Author_xml | – sequence: 1 givenname: Joelle surname: Sobngwi-Tambekou fullname: Sobngwi-Tambekou, Joelle organization: INSERM U687, Villejuif – sequence: 2 givenname: Dirk surname: Taljaard fullname: Taljaard, Dirk organization: Progressus and – sequence: 3 givenname: Pascale surname: Lissouba fullname: Lissouba, Pascale organization: INSERM U687, Villejuif – sequence: 4 givenname: Kevin surname: Zarca fullname: Zarca, Kevin organization: INSERM U687, Villejuif – sequence: 5 givenname: Adrian surname: Puren fullname: Puren, Adrian organization: National Institute for Communicable Diseases, Johannesburg, South Africa – sequence: 6 givenname: Emmanuel surname: Lagarde fullname: Lagarde, Emmanuel organization: INSERM U593, Bordeaux – sequence: 7 givenname: Bertran surname: Auvert fullname: Auvert, Bertran email: Bertran.auvert@uvsq.fr organization: INSERM U687, Villejuif |
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| Copyright | Copyright 2008 Infectious Diseases Society of America 2009 by the Infectious Diseases Society of America 2009 2009 INIST-CNRS Distributed under a Creative Commons Attribution 4.0 International License |
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| Keywords | Virus Human Infection Microbiology Follow up study Herpesviridae Alphaherpesvirinae Retroviridae Human herpesvirus 2 Human immunodeficiency virus Lentivirus |
| Language | English |
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| PublicationTitle | The Journal of infectious diseases |
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| References | 14605166 - J Clin Microbiol. 2003 Nov;41(11):5212-4 18685546 - Sex Transm Dis. 2008 Nov;35(11):946-59 9815213 - J Infect Dis. 1998 Dec;178(6):1616-22 17321310 - Lancet. 2007 Feb 24;369(9562):643-56 11399961 - AIDS. 2001 May 4;15(7):885-98 11867018 - Herpes. 2001 Jul;8(2):46-9 18493617 - PLoS One. 2008;3(5):e2230 4050778 - Am J Epidemiol. 1985 Nov;122(5):904-14 17630545 - AIDS. 2007 Jul 31;21(12):1515-23 6272110 - N Engl J Med. 1981 Dec 10;305(24):1439-44 15115628 - Herpes. 2004 Apr;11 Suppl 1:36A-45A 11834958 - AIDS. 2002 Feb 15;16(3):451-62 12721931 - J Infect Dis. 2003 May 15;187(10):1513-21 17405782 - Sex Transm Infect. 2007 Aug;83 Suppl 1:i17-24 11756980 - J Infect Dis. 2002 Jan 1;185(1):45-52 16581731 - Sex Transm Infect. 2006 Apr;82(2):101-9; discussion 110 15980695 - J Acquir Immune Defic Syndr. 2005 Jul 1;39(3):333-9 2828700 - JAMA. 1988 Feb 19;259(7):1048-50 16327322 - AIDS. 2006 Jan 2;20(1):73-83 16511420 - AIDS. 2006 Jan 9;20(2):261-7 15021308 - J Acquir Immune Defic Syndr. 2004 Apr 15;35(5):435-45 19367793 - J Infect Dis. 2009 Apr 1;199(7):923-5 15097305 - J Acquir Immune Defic Syndr. 2004 May 1;36(1):613-21 7407317 - Biometrics. 1980 Jun;36(2):299-305 9595616 - Stat Med. 1998 Apr 30;17(8):857-72 6871346 - Biometrics. 1983 Mar;39(1):173-84 10683059 - JAMA. 2000 Feb 9;283(6):791-4 11686471 - AIDS. 2001 Aug;15 Suppl 4:S97-108 16231970 - PLoS Med. 2005 Nov;2(11):e298 17321311 - Lancet. 2007 Feb 24;369(9562):657-66 15115627 - Herpes. 2004 Apr;11 Suppl 1:24A-35A 17396994 - J Infect Dis. 2007 May 1;195(9):1260-9 6652201 - Biometrics. 1983 Sep;39(3):665-74 7486467 - Ann Intern Med. 1995 Dec 1;123(11):845-7 |
| References_xml | – reference: 15097305 - J Acquir Immune Defic Syndr. 2004 May 1;36(1):613-21 – reference: 15980695 - J Acquir Immune Defic Syndr. 2005 Jul 1;39(3):333-9 – reference: 17321310 - Lancet. 2007 Feb 24;369(9562):643-56 – reference: 11756980 - J Infect Dis. 2002 Jan 1;185(1):45-52 – reference: 17405782 - Sex Transm Infect. 2007 Aug;83 Suppl 1:i17-24 – reference: 15115628 - Herpes. 2004 Apr;11 Suppl 1:36A-45A – reference: 17630545 - AIDS. 2007 Jul 31;21(12):1515-23 – reference: 9815213 - J Infect Dis. 1998 Dec;178(6):1616-22 – reference: 11686471 - AIDS. 2001 Aug;15 Suppl 4:S97-108 – reference: 17321311 - Lancet. 2007 Feb 24;369(9562):657-66 – reference: 12721931 - J Infect Dis. 2003 May 15;187(10):1513-21 – reference: 18685546 - Sex Transm Dis. 2008 Nov;35(11):946-59 – reference: 14605166 - J Clin Microbiol. 2003 Nov;41(11):5212-4 – reference: 15115627 - Herpes. 2004 Apr;11 Suppl 1:24A-35A – reference: 6272110 - N Engl J Med. 1981 Dec 10;305(24):1439-44 – reference: 16231970 - PLoS Med. 2005 Nov;2(11):e298 – reference: 7486467 - Ann Intern Med. 1995 Dec 1;123(11):845-7 – reference: 7407317 - Biometrics. 1980 Jun;36(2):299-305 – reference: 17396994 - J Infect Dis. 2007 May 1;195(9):1260-9 – reference: 18493617 - PLoS One. 2008;3(5):e2230 – reference: 15021308 - J Acquir Immune Defic Syndr. 2004 Apr 15;35(5):435-45 – reference: 19367793 - J Infect Dis. 2009 Apr 1;199(7):923-5 – reference: 9595616 - Stat Med. 1998 Apr 30;17(8):857-72 – reference: 4050778 - Am J Epidemiol. 1985 Nov;122(5):904-14 – reference: 16511420 - AIDS. 2006 Jan 9;20(2):261-7 – reference: 2828700 - JAMA. 1988 Feb 19;259(7):1048-50 – reference: 11399961 - AIDS. 2001 May 4;15(7):885-98 – reference: 11834958 - AIDS. 2002 Feb 15;16(3):451-62 – reference: 6871346 - Biometrics. 1983 Mar;39(1):173-84 – reference: 16581731 - Sex Transm Infect. 2006 Apr;82(2):101-9; discussion 110 – reference: 11867018 - Herpes. 2001 Jul;8(2):46-9 – reference: 6652201 - Biometrics. 1983 Sep;39(3):665-74 – reference: 10683059 - JAMA. 2000 Feb 9;283(6):791-4 – reference: 16327322 - AIDS. 2006 Jan 2;20(1):73-83 |
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| Snippet | 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... Background. The 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... The 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... BACKGROUND: The 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... |
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| SubjectTerms | 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 |
| Title | Effect of HSV-2 Serostatus on Acquisition of HIV by Young Men: Results of a Longitudinal Study in Orange Farm, South Africa |
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