Herpes simplex virus type-2 (HSV-2) cervico-vaginal shedding among women living with HIV-1 on antiretroviral therapy in Burkina Faso: an 8-year longitudinal study.


Low, AJ; Nagot, N; Weiss, HA; Konate, I; Kania, D; Segondy, M; Meda, N; van de Perre, P; Mayaud, P; Yerelon Study Group; , COLLABORATORS; Bahembera, E; Berthé, A; Coulibaly, M; Defer, MC; Diallo, R; Djagbaré, D; Huet, C; Konaté, I; Ky-Dama, F; M'Boutiki, GT; Méda, N; Millogo, I; Nagot, N; Ouédraogo, A; Ouédraogo, D; Rouet, F; Sanon, A; Sawadogo, H; Vallo, R; Vergne, L; Mayaud, P; Weiss, HA; Nagot, N; Becquart, P; Foulongne, V; Segondy, M; Van de Perre, P; Andonaba, JB; Sawadogo, A; (2016) Herpes simplex virus type-2 (HSV-2) cervico-vaginal shedding among women living with HIV-1 on antiretroviral therapy in Burkina Faso: an 8-year longitudinal study. The Journal of infectious diseases, 213 (5). pp. 731-7. ISSN 0022-1899 DOI: 10.1093/infdis/jiv495

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Abstract

BACKGROUND: The impact of antiretroviral therapy (ART) on herpes simplex virus type-2 (HSV-2) replication is unclear. The aim of this study was to assess factors associated with cervicovaginal HSV-2 DNA shedding and genital ulcer disease (GUD) in a cohort of women living with human immunodeficiency virus type-1 (HIV-1) in Burkina Faso.<br/> METHODS: Participants were screened for cervicovaginal HSV-2 DNA, GUD, cervicovaginal and systemic HIV-1 RNA, and reproductive tract infections every 3-6 months over 8 years. Associations with HSV-2 shedding and quantity were examined using random-effects logistic and linear regression, respectively.<br/> RESULTS: Of the 236 women with data on HSV-2 shedding, 151 took ART during the study period. Cervicovaginal HSV-2 DNA was detected in 42% of women (99 of 236) in 8.2% of visits (151 of 1848). ART was associated with a reduction in the odds of HSV-2 shedding, which declined for each year of ART use (odds ratio [OR], 0.74; 95% confidence interval [CI], .59-.92). In the multivariable model, the impact of ART was primarily associated with suppression of systemic HIV-1 RNA (adjusted OR, 0.32; 95% CI, .15-.67). A reduction in the odds of GUD was also observed during ART, mainly in those with HIV-1 suppression (adjusted OR, 0.53; 95% CI, .25-1.11).<br/> CONCLUSIONS: ART is strongly associated with a decrease in cervicovaginal HSV-2 shedding, and the impact was sustained over several years.<br/>

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Tropical Epidemiology Group
PubMed ID: 26475931
Web of Science ID: 372438300007
URI: http://researchonline.lshtm.ac.uk/id/eprint/2331662

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