Sexually transmitted bedfellows: Exquisite association between HIV and herpes simplex virus type 2 in 21 communities in Southern Africa in the HIV prevention trials network 071 (PopART) Study

on behalf of the HPTN 071 (PopART) Study Team

Research output: Contribution to journalArticle

Abstract

Background Human immunodeficiency virus (HIV) and herpes simplex virus type 2 (HSV2) are strongly associated, although mechanisms are not fully understood. An HIV prevention trial allowed reexamination of this association at individual and community levels. Methods The HIV Prevention Trials Network 071 (PopART) study evaluates a combination prevention intervention in 21 urban communities in Zambia and South Africa. To measure impact on HIV infection incidence, a cohort of approximately 2000 adults (age range, 18-44 years) was selected randomly from each community. Baseline data on sociodemographic characteristics, behavior, and HIV/HSV2 serologic findings were used to examine the association between HIV and HSV2. At the community level, HIV prevalence was plotted against HSV2 prevalence. Results A total of 38691 adults participated. HSV2 prevalence among women and men was 50% and 22%, respectively, in Zambia and 60% and 27%, respectively, in South Africa. Estimated HSV2 infection incidence among those aged 18-24 years was 8.06 cases/100 person-years (95% confidence interval [CI], 6.76-9.35) and 1.76 cases/100 person-years (95% CI, 1.30-2.22) among women and men, respectively. A 6-fold higher odds of HIV infection was seen in HSV2-infected individuals in both sexes, after adjustment for confounders (odds ratio, 6.66 [95% CI, 6.07-7.31] among women and 6.57 [95% CI, 5.56-7.77] among men). At the community-level, there was a strong linear relationship between HIV and HSV2 prevalence (I= 0.92; P <.001). Conclusions There was an exquisite association between these 2 infections, at the individual and community levels, likely due in part to a powerful cofactor effect of HSV2 on HIV transmission. HSV2 control could contribute to HIV prevention.

Original languageEnglish (US)
Pages (from-to)443-452
Number of pages10
JournalJournal of Infectious Diseases
Volume218
Issue number3
DOIs
StatePublished - Jul 2 2018
Externally publishedYes

Fingerprint

Southern Africa
Human Herpesvirus 2
HIV
Virus Diseases
Confidence Intervals
Zambia
South Africa
Incidence
Odds Ratio

Keywords

  • cofactor
  • ecological analysis
  • HIV
  • HSV2
  • South Africa
  • urban
  • Zambia

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

Cite this

@article{c074a8f8c0fd4a13a11a4b6fcd67841a,
title = "Sexually transmitted bedfellows: Exquisite association between HIV and herpes simplex virus type 2 in 21 communities in Southern Africa in the HIV prevention trials network 071 (PopART) Study",
abstract = "Background Human immunodeficiency virus (HIV) and herpes simplex virus type 2 (HSV2) are strongly associated, although mechanisms are not fully understood. An HIV prevention trial allowed reexamination of this association at individual and community levels. Methods The HIV Prevention Trials Network 071 (PopART) study evaluates a combination prevention intervention in 21 urban communities in Zambia and South Africa. To measure impact on HIV infection incidence, a cohort of approximately 2000 adults (age range, 18-44 years) was selected randomly from each community. Baseline data on sociodemographic characteristics, behavior, and HIV/HSV2 serologic findings were used to examine the association between HIV and HSV2. At the community level, HIV prevalence was plotted against HSV2 prevalence. Results A total of 38691 adults participated. HSV2 prevalence among women and men was 50{\%} and 22{\%}, respectively, in Zambia and 60{\%} and 27{\%}, respectively, in South Africa. Estimated HSV2 infection incidence among those aged 18-24 years was 8.06 cases/100 person-years (95{\%} confidence interval [CI], 6.76-9.35) and 1.76 cases/100 person-years (95{\%} CI, 1.30-2.22) among women and men, respectively. A 6-fold higher odds of HIV infection was seen in HSV2-infected individuals in both sexes, after adjustment for confounders (odds ratio, 6.66 [95{\%} CI, 6.07-7.31] among women and 6.57 [95{\%} CI, 5.56-7.77] among men). At the community-level, there was a strong linear relationship between HIV and HSV2 prevalence (I= 0.92; P <.001). Conclusions There was an exquisite association between these 2 infections, at the individual and community levels, likely due in part to a powerful cofactor effect of HSV2 on HIV transmission. HSV2 control could contribute to HIV prevention.",
keywords = "cofactor, ecological analysis, HIV, HSV2, South Africa, urban, Zambia",
author = "{on behalf of the HPTN 071 (PopART) Study Team} and John Bradley and Sian Floyd and Estelle Piwowar-Manning and Laeyendecker, {Oliver B.} and Alicia Young and Nomtha Bell-Mandla and Justin Bwalya and Peter Bock and Sarah Fidler and Helen Ayles and Hayes, {Richard J.}",
year = "2018",
month = "7",
day = "2",
doi = "10.1093/infdis/jiy178",
language = "English (US)",
volume = "218",
pages = "443--452",
journal = "Journal of Infectious Diseases",
issn = "0022-1899",
publisher = "Oxford University Press",
number = "3",

}

TY - JOUR

T1 - Sexually transmitted bedfellows

T2 - Exquisite association between HIV and herpes simplex virus type 2 in 21 communities in Southern Africa in the HIV prevention trials network 071 (PopART) Study

AU - on behalf of the HPTN 071 (PopART) Study Team

AU - Bradley, John

AU - Floyd, Sian

AU - Piwowar-Manning, Estelle

AU - Laeyendecker, Oliver B.

AU - Young, Alicia

AU - Bell-Mandla, Nomtha

AU - Bwalya, Justin

AU - Bock, Peter

AU - Fidler, Sarah

AU - Ayles, Helen

AU - Hayes, Richard J.

PY - 2018/7/2

Y1 - 2018/7/2

N2 - Background Human immunodeficiency virus (HIV) and herpes simplex virus type 2 (HSV2) are strongly associated, although mechanisms are not fully understood. An HIV prevention trial allowed reexamination of this association at individual and community levels. Methods The HIV Prevention Trials Network 071 (PopART) study evaluates a combination prevention intervention in 21 urban communities in Zambia and South Africa. To measure impact on HIV infection incidence, a cohort of approximately 2000 adults (age range, 18-44 years) was selected randomly from each community. Baseline data on sociodemographic characteristics, behavior, and HIV/HSV2 serologic findings were used to examine the association between HIV and HSV2. At the community level, HIV prevalence was plotted against HSV2 prevalence. Results A total of 38691 adults participated. HSV2 prevalence among women and men was 50% and 22%, respectively, in Zambia and 60% and 27%, respectively, in South Africa. Estimated HSV2 infection incidence among those aged 18-24 years was 8.06 cases/100 person-years (95% confidence interval [CI], 6.76-9.35) and 1.76 cases/100 person-years (95% CI, 1.30-2.22) among women and men, respectively. A 6-fold higher odds of HIV infection was seen in HSV2-infected individuals in both sexes, after adjustment for confounders (odds ratio, 6.66 [95% CI, 6.07-7.31] among women and 6.57 [95% CI, 5.56-7.77] among men). At the community-level, there was a strong linear relationship between HIV and HSV2 prevalence (I= 0.92; P <.001). Conclusions There was an exquisite association between these 2 infections, at the individual and community levels, likely due in part to a powerful cofactor effect of HSV2 on HIV transmission. HSV2 control could contribute to HIV prevention.

AB - Background Human immunodeficiency virus (HIV) and herpes simplex virus type 2 (HSV2) are strongly associated, although mechanisms are not fully understood. An HIV prevention trial allowed reexamination of this association at individual and community levels. Methods The HIV Prevention Trials Network 071 (PopART) study evaluates a combination prevention intervention in 21 urban communities in Zambia and South Africa. To measure impact on HIV infection incidence, a cohort of approximately 2000 adults (age range, 18-44 years) was selected randomly from each community. Baseline data on sociodemographic characteristics, behavior, and HIV/HSV2 serologic findings were used to examine the association between HIV and HSV2. At the community level, HIV prevalence was plotted against HSV2 prevalence. Results A total of 38691 adults participated. HSV2 prevalence among women and men was 50% and 22%, respectively, in Zambia and 60% and 27%, respectively, in South Africa. Estimated HSV2 infection incidence among those aged 18-24 years was 8.06 cases/100 person-years (95% confidence interval [CI], 6.76-9.35) and 1.76 cases/100 person-years (95% CI, 1.30-2.22) among women and men, respectively. A 6-fold higher odds of HIV infection was seen in HSV2-infected individuals in both sexes, after adjustment for confounders (odds ratio, 6.66 [95% CI, 6.07-7.31] among women and 6.57 [95% CI, 5.56-7.77] among men). At the community-level, there was a strong linear relationship between HIV and HSV2 prevalence (I= 0.92; P <.001). Conclusions There was an exquisite association between these 2 infections, at the individual and community levels, likely due in part to a powerful cofactor effect of HSV2 on HIV transmission. HSV2 control could contribute to HIV prevention.

KW - cofactor

KW - ecological analysis

KW - HIV

KW - HSV2

KW - South Africa

KW - urban

KW - Zambia

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U2 - 10.1093/infdis/jiy178

DO - 10.1093/infdis/jiy178

M3 - Article

C2 - 29659909

AN - SCOPUS:85050797193

VL - 218

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JO - Journal of Infectious Diseases

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