Prevalence, incidence and correlates of HSV-2 infection in an HIV incidence adolescent and adult cohort study in western Kenya.
Prevalence, incidence and correlates of HSV-2 infection in an HIV incidence adolescent and adult cohort study in western Kenya.
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DOI：
10.1371/journal.pone.0178907
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Zeh C
中科院分区：
文献类型：
--
作者：
Akinyi B;Odhiambo C;Otieno F;Inzaule S;Oswago S;Kerubo E;Ndivo R;Zeh C
单纯疱疹病毒2型（HSV-2）感染与HIV传播风险增加有关。我们确定了HSV-2的患病率、发病率和相关危险因素、结果不确定人群的发病率以及参加肯尼亚西部HIV发病率队列研究的年轻人（18-34岁）和青少年（16-17岁）中HSV-2/HIV合并感染的患病率。参与者（n = 1106; 846名成年人）进行了筛选，那些HIV-1阴性的人被招募并每季度随访一年。HSV-2采用Kalon酶免疫法检测。分别计算HSV-2血清阴性受试者和基线时不确定受试者的HSV-2发病率。Logistic回归用于估计HSV-2感染的几率，Poisson回归用于评估HSV-2的发病率和相关因素。总体而言，HSV-2患病率为26.6% [95%置信区间（CI）：23.9-29.4]，成人（31.5% [95% CI：28.3-34.9]）高于青少年（10.7% [95% CI：7.1-15.3]）。与HSV-2流行相关的因素包括女性、年龄增长、HIV感染、性传播感染史、教育水平低、多个性伴侣、已婚、离婚、分居或丧偶。总体HSV-2发生率为4.0/100人-年（/100 PY），95% CI：2.7-6.1，成人（4.5/100 PY）和女性（5.1/100 PY）的发生率较高。在多变量分析中，只有婚姻状况与HSV-2发病率相关。在基线时HSV-2结果不确定的45例受试者中，22例血清转化，导致发生率为53.2 /100 PY [95% CI：35.1-80.9]。纳入不确定结果后，总体发生率几乎翻倍至7.8 /100 PY [95% CI：5.9-10.5]。女性成人中HIV/HSV-2合并感染的患病率高于女性青少年（17.1 [95% CI：13.6-21.0] vs 3.4 [95% CI：1.1-7.8]）。结果不确定的人群中的高发病率强调了对HSV-2传播和HSV-2负担低报的公共卫生关注。在这些情况下解释HSV-2血清学结果时需要仔细考虑。
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. 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. 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]). 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.