2型单纯疱疹病毒及其他生殖器感染在坦桑尼亚北部高危女性感染HIV-1中的作用。

The role of herpes simplex virus type 2 and other genital infections in the acquisition of HIV-1 among high-risk women in northern Tanzania.

作者信息

Kapiga Saidi H, Sam Noel E, Bang Heejung, Ni Quanhong, Ao Trong T H, Kiwelu Ireen, Chiduo Sarah, Ndibe Uzodinma, Seage George, Coplan Paul, Shao John, Rosenberg Zeda F, Essex Max

机构信息

Department of Population and International Health, Harvard School of Public Health, Boston, MA 02115, USA.

出版信息

J Infect Dis. 2007 May 1;195(9):1260-9. doi: 10.1086/513566. Epub 2007 Mar 15.

DOI:10.1086/513566

PMID:17396994

Abstract

BACKGROUND

We examined the role of herpes simplex virus type 2 (HSV-2) and other genital infections on human immunodeficiency virus type 1 (HIV-1) incidence in a cohort study conducted between 2002 and 2005 among female bar/hotel workers in Moshi, Tanzania.

METHODS

At baseline and every 3 months thereafter, participants were interviewed, and blood and genital samples were collected. Predictors of HIV-1 incidence were evaluated using a Cox proportional hazards regression model.

RESULTS

Of 845 women who were HIV-1 seronegative at baseline, 689 (81.5%) were monitored in the study for a total of 698.6 person-years at risk (PYARs). The overall HIV-1 incidence was 4.6/100 PYARs (95% confidence interval [CI], 3.0-6.2/100 PYARs), and condom use was very low. After adjustment for other risk factors, the risk of HIV-1 was increased among women with HSV-2 at baseline (hazard ratio [HR], 4.3 [95% CI, 1.5-12.4]) and in those who acquired HSV-2 during the study period (HR, 5.5 [95% CI, 1.2-25.4]). Other independent predictors of HIV-1 were baseline chlamydial infection (HR, 5.2), bacterial vaginosis (HR, 2.1), and the occurrence of genital ulcers (HR, 2.7).

CONCLUSION

HSV-2 and other genital infections were the most important risk factors for HIV-1. Control of these infections could help to reduce HIV-1 incidence in this population.

摘要

背景

在2002年至2005年于坦桑尼亚莫希市对酒吧/酒店女性工作者开展的一项队列研究中，我们考察了2型单纯疱疹病毒（HSV-2）及其他生殖器感染对1型人类免疫缺陷病毒（HIV-1）发病率的影响。

方法

在基线期及此后每3个月，对参与者进行访谈，并采集血液和生殖器样本。使用Cox比例风险回归模型评估HIV-1发病率的预测因素。

结果

在基线时HIV-1血清学阴性的845名女性中，689名（81.5%）参与了该研究的监测，总计698.6人年的风险暴露时间（PYARs）。总体HIV-1发病率为4.6/100人年风险暴露时间（95%置信区间[CI]，3.0 - 6.2/100人年风险暴露时间），且安全套使用率很低。在对其他风险因素进行调整后，基线时感染HSV-2的女性中HIV-1感染风险增加（风险比[HR]，4.3[95%CI，1.5 - 12.4]），以及在研究期间感染HSV-2的女性中HIV-1感染风险增加（HR，5.5[95%CI，1.2 - 25.4]）。HIV-1的其他独立预测因素为基线时衣原体感染（HR，5.2）、细菌性阴道病（HR，2.1）以及生殖器溃疡的发生（HR，2.7）。