Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, P.O. Box 24144, Doha, Qatar.
World Health Organization Collaborating Centre for Disease Epidemiology Analytics On HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.
Sci Rep. 2020 Nov 9;10(1):19293. doi: 10.1038/s41598-020-76380-z.
This study investigated herpes simplex virus type 2 (HSV-2) seroprevalence utility as a predictor of HIV epidemic potential among female sex workers (FSWs) globally. We updated and analyzed a systematically-assembled database for paired HSV-2 and HIV seroprevalence measures among FSWs. The study identified 231 paired HSV-2/HIV prevalence measures from 40 countries. The pooled mean HIV prevalence using meta-analysis increased from 3.7% (95% CI 0.3-9.9%) among populations of FSWs with HSV-2 prevalence < 25% to 18.7% (95% CI 14.1-23.8%) among those with HSV-2 prevalence 75-100%. HIV prevalence was negligible in FSWs with HSV-2 prevalence ≤ 20% suggesting a threshold effect. Multivariable meta-regressions explained > 65% of HIV prevalence variation, and identified a strong positive HSV-2/HIV association. Compared to populations of FSWs with HSV-2 prevalence < 25%, adjusted odds ratios (AORs) of HIV infection increased from 2.8 (95% CI 1.2-6.3) in those with HSV-2 prevalence 25-49%, to 13.4 (95% CI 6.1-29.9) in those with HSV-2 prevalence 75-100%. HSV-2 is a strong predictor of HIV epidemic potential among FSWs. HSV-2 prevalence of 25-49% indicates potential for intermediate-intensity HIV epidemics, with higher levels indicative of large epidemics. HSV-2 surveillance could inform HIV preparedness in countries where HIV prevalence among FSWs is still limited or at zero-level.
本研究调查了单纯疱疹病毒 2 型 (HSV-2) 血清阳性率作为全球女性性工作者 (FSW) 中 HIV 流行潜力的预测指标。我们更新并分析了一个系统收集的 FSW 中 HSV-2 和 HIV 血清阳性率配对的数据库。该研究在 40 个国家确定了 231 对 HSV-2/HIV 流行率测量值。使用荟萃分析，合并后的 HIV 流行率从 HSV-2 流行率<25%的 FSW 人群中的 3.7%（95%CI 0.3-9.9%）增加到 HSV-2 流行率为 75-100%的人群中的 18.7%（95%CI 14.1-23.8%）。在 HSV-2 流行率≤20%的 FSW 中，HIV 流行率可以忽略不计，这表明存在阈值效应。多变量荟萃回归解释了 HIV 流行率变化的>65%，并确定了 HSV-2/HIV 之间的强正相关。与 HSV-2 流行率<25%的 FSW 人群相比，HSV-2 流行率为 25-49%的人群中 HIV 感染的调整比值比 (AOR) 从 2.8（95%CI 1.2-6.3）增加到 HSV-2 流行率为 75-100%的人群中的 13.4（95%CI 6.1-29.9）。HSV-2 是 FSW 中 HIV 流行潜力的有力预测指标。HSV-2 流行率为 25-49%表明存在中度强度的 HIV 流行，而更高的流行率则表明存在大规模流行。在 HIV 流行率仍有限或为零水平的国家，HSV-2 监测可以为 HIV 备灾提供信息。
