Ramjee G., Williams B., Gouws E., Van Dyck E., De Deken B., Karim S.A.
HIV-1 Prevention Research Unit, Medical Research Council, Durban, South Africa; Council for Scientific and Industrial Research, South Africa, Genève, Switzerland; Institute of Tropical Medicine, Antwerp, Belgium; University of Natal, Durban, South Africa; Columbia University, New York, NY, United States; Cornell University, Ithaca, NY, United States; 16 rue de la Canonnière, 1202 Genève 27, Switzerland
Ramjee, G., HIV-1 Prevention Research Unit, Medical Research Council, Durban, South Africa; Williams, B., Council for Scientific and Industrial Research, South Africa, Genève, Switzerland, 16 rue de la Canonnière, 1202 Genève 27, Switzerland; Gouws, E., Council for Scientific and Industrial Research, South Africa, Genève, Switzerland; Van Dyck, E., Institute of Tropical Medicine, Antwerp, Belgium; De Deken, B., Institute of Tropical Medicine, Antwerp, Belgium; Karim, S.A., University of Natal, Durban, South Africa, Columbia University, New York, NY, United States, Cornell University, Ithaca, NY, United States
This study investigated the impact of prevalent and incident HSV-2 infection on the incidence of HIV-1 infection in a cohort of female commercial sex workers in KwaZulu-Natal, South Africa. Prior to a vaginal microbicide trial, 416 women were screened for antibodies to HIV-1 and herpes simplex virus-2 (HSV-2) infections and a questionnaire was used to establish behavioral, social, and demographic characteristics. A total of 187 HIV-1-seronegative women were followed up at monthly intervals when blood was drawn and used to detect HIV-1 and HSV-2 antibodies. The median duration of follow-up was 2.2 years. At screening 50% of the women were HIV-1 seropositive and 84% were HSV-2 seropositive. The hazards of HIV-1 among women who were HSV-2 seropositive or seronegative throughout, or among those who seroconverted during the study, were not significantly different. When HSV-2 seroconversion was analyzed as a time-dependent covariate, the hazard ratio for HIV-1 seroconversion was 6.0 (95% CI: 2.6-14.0) times greater among women with incident than among women with prevalent HSV-2 infections. Drawing on other recent studies these data suggest that incident HSV-2 infection increases the risk of HIV-1 infection; the effect wanes with time since infection; and the effect is significantly greater for men than it is for women. Copyright © 2005 by Lippincott Williams & Wilkins.
herpes simplex virus antibody; Human immunodeficiency virus antibody; unclassified drug; virus antibody; adult; antibody detection; article; clinical article; cohort analysis; female; herpes simplex; Herpes simplex virus 2; human; Human immunodeficiency virus 1; Human immunodeficiency virus infection; incidence; infection risk; male; prevalence; priority journal; prostitution; seroprevalence; South Africa; Adolescent; Adult; Anti-Infective Agents; Female; Herpes Genitalis; Herpesvirus 2, Human; HIV Infections; HIV Seropositivity; HIV-1; Humans; Middle Aged; Nonoxynol; Proportional Hazards Models; Prostitution; Risk Factors; South Africa; Time Factors; Vaginal Creams, Foams, and Jellies