Foss, Anna M; Vickerman, Peter T; Mayaud, Philippe; Weiss, Helen A; Ramesh, BM; Reza-Paul, Sushena; Washington, Reynold; Blanchard, James; Moses, Stephen; Lowndes, Catherine M; +2 more... Alary, Michel; Watts, Charlotte H; (2011) Modelling the interactions between herpes simplex virus type 2 and HIV: implications for the HIV epidemic in southern India. Sexually transmitted infections, 87 (1). pp. 22-27. ISSN 1368-4973 DOI: https://doi.org/10.1136/sti.2009.041699
Permanent Identifier
Use this Digital Object Identifier when citing or linking to this resource.
Abstract
BACKGROUND: The role of herpes simplex virus type 2 (HSV-2) in the HIV epidemic and the potential impact of HSV-2 suppressive therapy have previously been explored only within the context of sub-Saharan Africa. In this analysis, modelling is used to estimate the contribution of HSV-2 to HIV transmission from clients to female sex workers (FSW) in a southern Indian setting and the maximum potential impact of 'perfect' HSV-2 suppressive therapy on HIV incidence. METHODS: A dynamic HSV-2/HIV model was developed, parameterised and fitted to Mysore data. The model estimated the attributable fractions of HIV infections due to HSV-2. Multivariate sensitivity analyses and regression analyses were conducted. RESULTS: The model suggests that 36% (95% CI 22% to 62%) of FSW HIV infections were due to HSV-2, mostly through HSV-2 asymptomatic shedding. Even if HSV-2 suppressive therapy could eliminate the effect of HSV-2 on HIV infectivity among all co-infected clients, only 15% (95% CI 3% to 41%) of HIV infections among FSW would have been averted. 36% (95% CI 18% to 61%) of HIV infections among HSV-2-infected FSW could have been averted if suppressive therapy reduced their risk of HIV acquisition to that of HSV-2-uninfected FSW. CONCLUSIONS: HSV-2 contributes substantially to HIV in this southern Indian context. However, even in the best case scenario, HSV-2 suppressive therapy is unlikely to reduce HIV transmission or acquisition by more than 50% (as aimed for in recent trials), because of the limited strength of the interaction effect between HSV-2 and HIV.
Item Type | Article |
---|---|
Faculty and Department |
Faculty of Public Health and Policy > Dept of Global Health and Development Faculty of Infectious and Tropical Diseases > Dept of Clinical Research Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology & International Health (2023-) |
Research Centre | Tropical Epidemiology Group |
PubMed ID | 21059838 |
ISI | 286223800007 |
Related URLs |
Download
Filename: Modelling the interactions between Herpes_GREEN AAM.pdf
Licence: Creative Commons: Attribution-Noncommercial-No Derivative Works 3.0
Download