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Sex Transm Infect 92:76-82 doi:10.1136/sextrans-2014-051975
  • Epidemiology
  • Original article

Risk factors for incident HSV-2 infections among a prospective cohort of HIV-1-discordant couples in China

  1. Na He1
  1. 1Department of Epidemiology, School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
  2. 2National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
  3. 3Dehong Prefecture Center for Disease Control and Prevention, Mangshi, Yunnan Province, China
  4. 4Department of Epidemiology, School of Public Health, University of California, Los Angeles, Los Angeles, USA
  1. Correspondence to Dr Na He, Department of Epidemiology, School of Public Health, Fudan University, Shanghai, 200032, China; nhe{at}shmu.edu.cn
  • Received 16 December 2014
  • Revised 19 May 2015
  • Accepted 13 June 2015
  • Published Online First 2 July 2015

Abstract

Objectives Identification of risk factors is essential for developing herpes simplex virus type 2 (HSV-2) prevention interventions that could also reduce HIV-1 transmission, particularly among HIV-1-discordant couples.

Methods A prospective cohort study was conducted among HIV-1-discordant couples from June 2009 to March 2011 in Yunnan province, China. 413 HIV-1-infected partners and 517 HIV-1-uninfected partners who were HSV-2 seronegative or equivocal at enrolment and who had a study partner completing the baseline survey and HSV-2 testing were included in the analysis.

Results HSV-2 incidence was 2.9 per 100 person-years (PY) for HIV-1-infected partners and 4.5 per 100 PY for HIV-1-uninfected partners. At least 36% of incident HSV-2 infections were from outside sexual partner. Among HIV-1-infected partners, multivariate analysis indicated that HSV-2 incidence was significantly higher among those with baseline equivocal HSV-2 result, having an initially HSV-2 seropositive or equivocal partner, reporting no sex with study partner and initiating antiretroviral therapy (ART) during follow-up. Among HIV-1-uninfected partners, multivariate analysis indicated that HSV-2 incidence was significantly higher among those having an initially HSV-2 seropositive partner and reporting sex with study partner ≥5 times/month, but was lower among those having a partner with baseline CD4+ count ≥350 cells/μL.

Conclusions Our findings underscore the importance of developing prevention and intervention programmes to reduce HSV-2 transmission among this population. The relationship between ART initiation and HSV-2 seroconversion requires further investigation.