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Herpes simplex type 2 (HSV-2) trends in relation to the HIV epidemic in northern Malawi
  1. Judith R Glynn (judith.glynn{at}
  1. London School of Hygiene and Tropical Medicine, United Kingdom
    1. Amelia C Crampin
    1. London School of Hygiene & Tropical Medicine, United Kingdom
      1. Bagrey MM Ngwira
      1. Karonga Prevention Study, Malawi
        1. Richard Ndhlovu
        1. Karonga Prevention Study, Malawi
          1. Oram Mwanyongo
          1. Karonga Prevention Study, Malawi
            1. Paul EM Fine
            1. London School of Hygiene & Tropical Medicine, United Kingdom


              Objectives:It is unclear whether the high HSV-2 prevalence found in much of Africa predates the HIV epidemic or is, to some extent, a consequence of it. We sought to assess HSV-2 prevalence trends in a rural African community over a period in which HIV prevalence rose sharply, and to explore antenatal clinic surveillance as a method of estimating community HSV-2 prevalence.

              Methods: HSV-2 seroprevalence was determined among community controls seen for case-control studies of mycobacterial disease in Karonga District, Malawi 1988-90, 1998-2001 and 2002-5, and in women attending antenatal clinics (ANC) as part of surveillance for HIV in 1999-2000. Over this period HIV prevalence rose from 4% to 12%.

              Results: HSV-2 prevalence in all periods increased sharply with age and was higher in women than in men. After adjusting for differences in sampling, there was no evidence of change in HSV-2 prevalence in the different periods. Women in the ANC had lower HSV-2 prevalence than those in the community, but the ANC prevalence was a good approximation to the combined male and female prevalence for the same age group.

              Conclusions: This study suggests that HSV-2 was already widespread before the HIV epidemic and has not been greatly influenced by it. It also demonstrates that ANC surveillance may be useful for estimating community HSV-2 prevalence.

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