Article Text

Download PDFPDF

P3.224 Effect of Herpes Simplex Virus Type 2 (HSV-2) Infection on Progression of HIV Infection Among Female Sex Workers in Burkina Faso
  1. I T Traore1,
  2. I Konate2,
  3. N Meda1,2,
  4. W Bazie2,
  5. M N Hema1,
  6. A Kabore2,
  7. D Kania2,
  8. P Mayaud3,
  9. P Van De Perre4,5,
  10. N Nagot4,5
  1. 1University of Ouagadougou, Ouagadougou, Burkina Faso
  2. 2Centre Muraz, Bobo-Dioulasso, Burkina Faso
  3. 3London School of Hygiene and Tropical Medicine, London, UK
  4. 4University of Montpellier, Montpellier, France
  5. 5Unité INSERM U1058, Montpellier, France


Background The effect of HSV-2 on the natural history of HIV-1 remains unclear. Although trials have shown a modest but significant impact of HSV-2 suppression on HIV-1 disease progression, the sub-optimal antiviral efficacy of aciclovir and its potential antiretroviral effect have limited our ability to measure the true effect of HSV-2 on HIV-1 disease progression. This study aimed to assess the effect of untreated HSV-2 infection on the time to ART.

Methods From December 2003 to February 2012, HIV-1 infected female sex workers were enrolled in a prospective open cohort in Burkina Faso. At each 3-month follow-up visits, CD4 count and HIV-1 plasma viral load were done. Participants were offered care including ART and psychological support. Participants not on ART and having at least 350 CD4 cells/µl at enrolment (the current CD4 count threshold for ART initiation) were included in this analysis, which was censored at 36 months of follow-up when the assumption of proportional hazard was no longer met.

Results Overall, 164 co-infected women and 20 HIV-1 mono-infected women were enrolled in this study. At enrollment, the only difference between the two groups was a younger age of HIV-1 mono-infected women (median age 24 versus 31 years, p < 0.001). In linear mixed models, the age-adjusted mean CD4 count at baseline (intercept) was significantly lower among HSV-2 positive women (–211 cell/µL, p < 0.001), but no difference in baseline CD4-adjusted plasma viral load was observed. During follow-up, 3 out 20 HIV-1 mono-infected women initiated ART versus 52 out of 164 HSV-2 co-infected women. After adjustment for baseline CD4 count and age, HSV-2 infected women were still much more likely to initiate ART over 36 months (HR = 4.6, CI 95%: 1.04–20.5, p = 0.04).

Conclusion HIV-1 disease progression, as assessed by time to ART eligibility, was much accelerated for women co-infected with HSV-2.

  • Co-infection
  • HIV
  • HSV-2

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.