The role of herpes simplex virus type 2 and other genital infections in the acquisition of HIV-1 among high-risk women in northern Tanzania
The role of herpes simplex virus type 2 and other genital infections in the acquisition of HIV-1 among high-risk women in northern Tanzania
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DOI：
10.1086/513566
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发表时间：
2007-05-01
影响因子：
6.4
通讯作者：
Essex, Max
中科院分区：
文献类型：
--
作者：
Kapiga, Saidi H.;Sam, Noel E.;Essex, Max
背景我们于2002年至2005年在坦桑尼亚莫希的酒吧/酒店女性工作者中进行了一项队列研究，研究单纯疱疹病毒2型（HSV-2）和其他生殖器感染对人类免疫缺陷病毒1型（HIV-1）发病率的影响。在基线和此后每3个月，参与者接受采访，并收集血液和生殖器样本。采用考克斯比例风险回归模型评估HIV-1发病率的预测因子。在基线时HIV-1血清阴性的845名妇女中，有689名（81.5%）在研究中接受了监测，共计698.6人-年的风险（PYAR）。总体HIV-1发病率为4.6/100 PYAR（95%置信区间[ CI]，3.0-6.2/100 PYAR），安全套使用率非常低。校正其他风险因素后，基线时HSV-2女性患者的HIV-1风险增加（风险比[ HR]，4.3 [ 95% CI，1.5-12.4]），研究期间获得HSV-2的患者的HIV-1风险增加（HR，5.5 [ 95% CI，1.2-25.4]）。HIV-1的其他独立预测因子为基线衣原体感染（HR，5.2）、细菌性阴道病（HR，2.1）和生殖器溃疡的发生（HR，2.7）。HSV-2和其他生殖器感染是HIV-1最重要的危险因素。控制这些感染可能有助于降低这一人群中的HIV-1发病率。
Background. We examined the role of herpes simplex virus type 2 ( HSV-2) and other genital infections on human immunodeficiency virus type 1 ( HIV-1) incidence in a cohort study conducted between 2002 and 2005 among female bar/hotel workers in Moshi, Tanzania.Methods. At baseline and every 3 months thereafter, participants were interviewed, and blood and genital samples were collected. Predictors of HIV-1 incidence were evaluated using a Cox proportional hazards regression model.Results. Of 845 women who were HIV-1 seronegative at baseline, 689 ( 81.5%) were monitored in the study for a total of 698.6 person-years at risk ( PYARs). The overall HIV-1 incidence was 4.6/100 PYARs ( 95% confidence interval [ CI], 3.0-6.2/100 PYARs), and condom use was very low. After adjustment for other risk factors, the risk of HIV-1 was increased among women with HSV-2 at baseline ( hazard ratio [ HR], 4.3 [ 95% CI, 1.5-12.4]) and in those who acquired HSV-2 during the study period ( HR, 5.5 [ 95% CI, 1.2-25.4]). Other independent predictors of HIV-1 were baseline chlamydial infection ( HR, 5.2), bacterial vaginosis ( HR, 2.1), and the occurrence of genital ulcers ( HR, 2.7).Conclusion. HSV-2 and other genital infections were the most important risk factors for HIV-1. Control of these infections could help to reduce HIV-1 incidence in this population.