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

J Infect Dis. 2007 May 1;195(9):1260-9. doi: 10.1086/513566. Epub 2007 Mar 15.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cohort Studies
  • Female
  • HIV Infections / blood
  • HIV Infections / complications
  • HIV Infections / epidemiology*
  • HIV Infections / prevention & control
  • HIV-1*
  • Herpes Simplex / blood
  • Herpes Simplex / complications
  • Herpes Simplex / epidemiology*
  • Herpes Simplex / prevention & control
  • Herpesvirus 2, Human*
  • Humans
  • Incidence
  • Middle Aged
  • Prospective Studies
  • Risk Factors
  • Sexual Behavior*
  • Sexually Transmitted Diseases / blood
  • Sexually Transmitted Diseases / complications
  • Sexually Transmitted Diseases / epidemiology
  • Sexually Transmitted Diseases / prevention & control
  • Surveys and Questionnaires
  • Tanzania / epidemiology