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- Title
Genital Herpes Simplex Virus Type 2 Shedding Among Adults With and Without HIV Infection in Uganda.
- Authors
Phipps, Warren; Nakku-Joloba, Edith; Krantz, Elizabeth M.; Selke, Stacy; Meei-Li Huang; Kambugu, Fred; Orem, Jackson; Casper, Corey; Corey, Lawrence; Wald, Anna; Huang, Meei-Li
- Abstract
<bold>Background: </bold>Despite the high prevalence of herpes simplex virus type 2 (HSV-2) in sub-Saharan Africa, the natural history of infection among Africans is not well characterized. We evaluated the frequency of genital HSV shedding in HIV-seropositive and HIV-seronegative men and women in Uganda.<bold>Methods: </bold>Ninety-three HSV-2-seropositive Ugandan adults collected anogenital swab specimens for HSV DNA quantification by polymerase chain reaction 3 times daily for 6 weeks.<bold>Results: </bold>HSV-2 was detected from 2484 of 11 283 swab specimens collected (22%), with a median quantity of 4.3 log10 HSV copies/mL (range, 2.2-8.9 log10 HSV copies/mL). Genital lesions were reported on 749 of 3875 days (19%), and subclinical HSV shedding was detected from 1480 of 9113 swab specimens (16%) collected on days without lesions. Men had higher rates of total HSV shedding (relative risk [RR], 2.0 [95% confidence interval {CI}, 1.3-2.9]; P < .001); subclinical shedding (RR, 1.7 [95% CI, 1.1-2.7]; P = .01), and genital lesions (RR, 2.1 [95% CI, 1.2-3.4]; P = .005), compared with women. No differences in shedding rates or lesion frequency were observed based on HIV serostatus.<bold>Conclusions: </bold>HSV-2 shedding frequency and quantity are high among HSV-2-seropositive adults in sub-Saharan Africa, including persons with and those without HIV infection. Shedding rates were particularly high among men, which may contribute to the high prevalence of HSV-2 and early acquisition among African women.
- Subjects
HERPES genitalis; HERPES simplex virus; HIV infections; VIRAL shedding; HIV-positive persons; CONFIDENCE intervals; POLYMERASE chain reaction
- Publication
Journal of Infectious Diseases, 2016, Vol 213, Issue 3, p439
- ISSN
0022-1899
- Publication type
journal article
- DOI
10.1093/infdis/jiv451