Des Jarlais Don C, Arasteh Kamyar, Feelemyer Jonathan, McKnight Courtney, Tross Susan, Perlman David C, Campbell Aimee N C, Hagan Holly, Cooper Hannah L F
From the *Icahn School of Medicine at Mount Sinai; †New York State Psychiatric Institute, Department of Psychiatry, Columbia University Medical Center; ‡College of Nursing, New York University, New York, NY; and §Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA.
Sex Transm Dis. 2017 Feb;44(2):85-90. doi: 10.1097/OLQ.0000000000000549.
Herpes simplex virus type 2 (HSV-2) infection increases both susceptibility to and transmissibility of human immunodeficiency virus (HIV), and HSV-2 and HIV are often strongly associated in HIV epidemics. We assessed trends in HSV-2 prevalence among non-injecting drug users (NIDUs) when HIV prevalence declined from 16% to 8% among NIDUs in New York City.
Subjects were current non-injecting users of heroin and/or cocaine and who had never injected illicit drugs. Three thousand one hundred fifty-seven NIDU subjects were recruited between 2005 and 2014 among persons entering Mount Sinai Beth Israel substance use treatment programs. Structured interviews, HIV, and HSV-2 testing were administered. Change over time was assessed by comparing 2005 to 2010 with 2011 to 2014 periods. Herpes simplex virus type 2 incidence was estimated among persons who participated in multiple years.
Herpes simplex virus type 2 prevalence was strongly associated with HIV prevalence (odds ratio, 3.9; 95% confidence interval, 2.9-5.1) from 2005 to 2014. Herpes simplex virus type 2 prevalence declined from 60% to 56% (P = 0.01). The percentage of NIDUs with neither HSV-2 nor HIV infection increased from 37% to 43%, (P < 0.001); the percentage with HSV-2/HIV coinfection declined from 13% to 6% (P < 0.001). Estimated HSV-2 incidence was 1 to 2/100 person-years at risk.
There were parallel declines in HIV and HSV-2 among NIDUs in New York City from 2005 to 2014. The increase in the percentage of NIDUs with neither HSV-2 nor HIV infection, the decrease in the percentage with HSV-2/HIV coinfection, and the low to moderate HSV-2 incidence suggest some population-level protection against resurgence of HIV. Prevention efforts should be strengthened to end the combined HIV/HSV-2 epidemic among NIDUs in New York City.
2型单纯疱疹病毒（HSV - 2）感染会增加人类免疫缺陷病毒（HIV）的易感性和传播性，并且在HIV流行中，HSV - 2与HIV常常紧密相关。我们评估了纽约市非注射吸毒者（NIDU）中HIV患病率从16%下降至8%时HSV - 2患病率的变化趋势。
研究对象为当前使用海洛因和/或可卡因的非注射吸毒者，且从未注射过非法药物。2005年至2014年间，在进入西奈山贝斯以色列物质使用治疗项目的人群中招募了3157名NIDU受试者。进行了结构化访谈、HIV和HSV - 2检测。通过比较2005年至2010年与2011年至年14这两个时间段来评估随时间的变化。对参与多年的人群估计了2型单纯疱疹病毒的发病率。
2005年至2014年期间，2型单纯疱疹病毒患病率与HIV患病率密切相关（优势比为3.9；95%置信区间为2.9 - 5.1）。2型单纯疱疹病毒患病率从60%降至56%（P = 0.01）。既无HSV - 2感染也无HIV感染的NIDU比例从37%增至43%（P < 0.001）；HSV - 2/HIV合并感染比例从13%降至6%（P < 0.001）。估计HSV - 2发病率为每100人年1至2例。
2005年至2014年期间，纽约市NIDU中HIV和HSV - 2患病率呈平行下降趋势。既无HSV - 2感染也无HIV感染的NIDU比例增加、HSV - 2/HIV合并感染比例下降以及HSV - 2发病率低至中等，这表明在人群层面存在一定程度预防HIV复发的保护作用。应加强预防工作，以终结纽约市NIDU中HIV/HSV - 2合并流行的局面。
