在美国的当代 HIV 感染者队列中，单纯疱疹病毒-2 感染的流行情况及相关危险因素。
Prevalence and risk factors associated with herpes simplex virus-2 infection in a contemporary cohort of HIV-infected persons in the United States.
机构信息
Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
出版信息
Sex Transm Dis. 2012 Feb;39(2):154-60. doi: 10.1097/OLQ.0b013e318239d7fd.
BACKGROUND
We compared the herpes simplex virus type 2 (HSV-2) seroprevalence in a contemporary HIV cohort with the general US population and determined risk factors for HSV-2 infection among HIV-infected persons.
METHODS
The Study to Understand the Natural History of HIV and AIDS in the Era of Effective Therapy (SUN) Study is a prospective observational cohort of 700 HIV-infected adults enrolled in 4 U.S. cities between 2004 and 2006. At baseline, participants completed a behavioral risk questionnaire and provided specimens for HSV-2 serology. We calculated HSV-2 seroprevalence, standardized by age, gender, and race among HIV-infected persons compared with the general US adult population, using data from the National Health and Nutrition Examination Survey from 2003 to 2006. We examined risk factors associated with HSV-2 infection among HIV-infected persons using multivariate logistic regression.
RESULTS
Among 660 (94%) SUN participants with adequate specimens for HSV-2 serologic testing, 548 (83%) were 20 to 49 years old (median age, 39 years; 77% male; 59% non-Hispanic white; median CD4 count, 470 cells/mm; 74% with HIV RNA viral loads <400 copies/mL). HSV-2 seroprevalence was significantly higher among HIV-infected adults (59.7%, 95% confidence interval: 55.8-63.6) compared with the general US population (19.2%, 95% confidence interval: 17.5-21.1). In multivariate analysis, we found that older age, female gender, black non-Hispanic race/ethnicity, being currently unemployed, high-risk anal HPV infection, and longer duration since HIV diagnosis were associated with significantly higher odds of HSV-2 infection.
CONCLUSION
HSV-2 seroprevalence is 3 times as high among HIV-infected adults as in the general U.S. population. Clinicians should be aware that increased risk for HSV-2 infection was distributed broadly among HIV-infected persons and not limited to those with high-risk sexual behaviors.
背景
我们比较了在当代 HIV 队列中单纯疱疹病毒 2 型 (HSV-2) 的血清流行率与美国普通人群，并确定了 HIV 感染者中 HSV-2 感染的危险因素。
方法
在有效的治疗时代了解 HIV 和艾滋病自然史的研究 (SUN) 是一项前瞻性观察队列研究，纳入了 2004 年至 2006 年间在美国 4 个城市登记的 700 名 HIV 感染成年人。在基线时，参与者完成了行为风险问卷，并提供了 HSV-2 血清学检测标本。我们根据 2003 年至 2006 年全国健康和营养检查调查的数据，计算了 HIV 感染者与美国普通成年人群相比，按年龄、性别和种族标准化的 HSV-2 血清阳性率。我们使用多变量逻辑回归检查了 HIV 感染者中与 HSV-2 感染相关的危险因素。
结果
在 660 名 (94%) 有足够 HSV-2 血清学检测标本的 SUN 参与者中，548 名 (83%) 年龄在 20 至 49 岁之间(中位数年龄 39 岁；77% 为男性；59% 为非西班牙裔白人；中位数 CD4 计数为 470 个细胞/mm；74% 的 HIV RNA 病毒载量 <400 拷贝/ml)。与美国普通人群(19.2%，95%置信区间：17.5-21.1)相比，HIV 感染者的 HSV-2 血清阳性率显著更高(59.7%，95%置信区间：55.8-63.6)。在多变量分析中，我们发现年龄较大、女性、非裔美国人、目前失业、高风险肛门 HPV 感染和 HIV 诊断后时间较长与 HSV-2 感染的可能性显著增加有关。
结论
与美国普通人群相比，HIV 感染者的 HSV-2 血清阳性率高 3 倍。临床医生应该意识到，HIV 感染者中 HSV-2 感染的风险增加广泛分布，而不仅仅局限于具有高危性行为的人群。
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