HSV-2 serology can be predictive of HIV epidemic potential and hidden sexual risk behavior in the Middle East and North Africa.

HSV-2 serology can be predictive of HIV epidemic potential and hidden sexual risk behavior in the Middle East and North Africa.
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DOI:
10.1016/j.epidem.2010.08.003
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发表时间:
2010-12
期刊:
影响因子:
3.8
通讯作者:
Wilson, David
Wilson, David
中科院分区:
医学2区
文献类型:
--
作者:
Abu-Raddad, Laith J.;Schiffer, Joshua T.;Ashley, Rhoda;Mumtaz, Ghina;Alsallaq, Ramzi A.;Akala, Francisca Ayodeji;Semini, Iris;Riedner, Gabriele;Wilson, David

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中东和北非 (MENA) 地区的艾滋病毒感染率较低,但未来进一步传播的风险或潜力尚不清楚。该地区的行为调查有限,而且在评估艾滋病毒感染风险方面也存在严重局限性。我们证明了 2 型单纯疱疹病毒 (HSV-2) 血清流行率作为中东和北非地区 HIV 风险标记的潜在用途。我们设计了一个数学模型来评估 HSV-2 流行率是否可以预测未来的 HIV 传播。我们还对中东和北非地区的 HSV-2 血清流行率研究进行了系统的文献综述。我们发现该地区的 HSV-2 流行率数据相当有限。一般人群中的患病率通常较低,但在容易感染性传播感染的既定核心群体中,例如男男性行为者和女性性工作者中,患病率很高。我们的模型预测,如果 HSV-2 患病率较低且稳定,则未来 HIV 流行的风险较低。然而,HSV-2 流行率的扩大或较高(大于约 20%)意味着 HIV 流行的风险相当大。根据现有的 HSV-2 流行率数据,中东和北非地区的普通人群不太可能正在或将经历如此大规模的艾滋病毒流行。尽管如此,艾滋病毒在几个高危核心群体中集中流行的风险很高。 HSV-2 流行率调查为识别和证实中东和北非地区艾滋病毒高危人群提供了一种有用的机制。 HSV-2 血清学提供了一种有效的工具,可在高质量行为数据有限的地区探测隐藏的风险行为。
HIV prevalence is low in the Middle East and North Africa (MENA) region, though the risk or potential for further spread in the future is not well understood. Behavioral surveys are limited in this region and when available have serious limitations in assessing the risk of HIV acquisition. We demonstrate the potential use of herpes simplex virus-2 (HSV-2) seroprevalence as a marker for HIV risk within MENA. We designed a mathematical model to assess whether HSV-2 prevalence can be predictive of future HIV spread. We also conducted a systematic literature review of HSV-2 seroprevalence studies within MENA. We found that HSV-2 prevalence data are rather limited in this region. Prevalence is typically low among the general population but high in established core groups prone to sexually transmitted infections such as men who have sex with men and female sex workers. Our model predicts that if HSV-2 prevalence is low and stable, then the risk of future HIV epidemics is low. However, expanding or high HSV-2 prevalence (greater than about 20%), implies a risk for a considerable HIV epidemic. Based on available HSV-2 prevalence data, it is not likely that the general population in MENA is experiencing or will experience such a considerable HIV epidemic. Nevertheless, the risk for concentrated HIV epidemics among several high-risk core groups is high. HSV-2 prevalence surveys provide a useful mechanism for identifying and corroborating populations at risk for HIV within MENA. HSV-2 serology offers an effective tool for probing hidden risk behaviors in a region where quality behavioral data are limited.
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