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Open Access Research article

Risk Factors for HSV-2 Infection among Sexual Partners of HSV-2/HIV-1 Co-Infected Persons

Andrew Mujugira1*, Amalia S Magaret2, Jared M Baeten134, Connie Celum134 and Jairam Lingappa135

Author Affiliations

1 Department of Global Health, University of Washington, Seattle, WA, USA

2 Department of Laboratory Medicine, University of Washington, Seattle, WA, USA

3 Department of Medicine, University of Washington, Seattle, WA, USA

4 Department of Epidemiology, University of Washington, Seattle, WA, USA

5 Department of Pediatrics, University of Washington, Seattle, WA, USA

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BMC Research Notes 2011, 4:64  doi:10.1186/1756-0500-4-64

Published: 15 March 2011

Abstract

Background

Herpes simplex virus type 2 (HSV-2) is the most frequent cause of genital ulcer disease worldwide and has been associated with increased risk for HIV-1 acquisition and transmission. We conducted a cross-sectional analysis of risk factors for HSV-2 infection among HIV-1 uninfected partners, whose partners were co-infected with HIV-1 and HSV-2.

Methods

Between November 2004 and April 2007, 3408 HIV-discordant couples, in which the HIV-1 infected partners were HSV-2 seropositive with CD4 250 cells/mm3 or greater, were enrolled in an HSV-2 suppression trial to prevent HIV-1 transmission at 14 sites in 7 African countries. Clinical & behavioral data, HSV-2 and HIV-1 testing were conducted at enrolment. Univariate and multivariate Poisson regression analyses were performed separately, by gender of the HIV-1 infected partner.

Results

Among 3354 HIV-1 uninfected participants, 32% were female and overall 71% were HSV-2 seropositive. Among couples with female HIV-1 infected partners, HIV-1 plasma RNA [aPR 1.03; 95% CI: 0.99 to 1.06; p = 0.11] and CD4 count [aPR 1.00; 95% CI: 0.98 to 1.01; p = 0.48] in the HSV-2/HIV-1 dually infected female and circumcision in the HIV-1 uninfected male partner [aPR 0.94; 95% CI: 0.88 to 1.00; p = 0.06] were not associated with reduced risk of HSV-2 seropositivity, after adjusting for other factors.

Conclusions

In this cross-sectional analysis of African HIV-1 serodiscordant heterosexual couples with prevalent HSV-2 infection in the HIV-1 infected partner, HIV-1 plasma RNA and CD4 count in the dually-infected partner and male circumcision in the HIV-1 uninfected partner were not associated with HSV-2 concordance.

Trial Registration

ClinicalTrials.gov NCT00194519