dc.contributor.author | Drake, AL | |
dc.contributor.author | John-Stewart, GC | |
dc.contributor.author | Wald, A | |
dc.contributor.author | Mbori-Ngacha, DA | |
dc.contributor.author | Bosire, R | |
dc.contributor.author | Wamalwa, DC | |
dc.contributor.author | Lohman-Payne, BL | |
dc.contributor.author | Ashley-Morrow, R | |
dc.contributor.author | Corey, L | |
dc.contributor.author | Farquhar, C | |
dc.date.accessioned | 2013-05-02T14:31:24Z | |
dc.date.available | 2013-05-02T14:31:24Z | |
dc.date.issued | 2007 | |
dc.identifier.citation | Obstet Gynecol. 2007 Feb;109(2 Pt 1):403-9 | en |
dc.identifier.uri | http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/18490 | |
dc.identifier.uri | http://www.ncbi.nlm.nih.gov/pubmed/17267842 | |
dc.description.abstract | OBJECTIVE:
To determine whether herpes simplex virus type 2 (HSV-2) infection was associated with risk of intrapartum human immunodeficiency virus type 1 (HIV-1) transmission and to define correlates of HSV-2 infection among HIV-1-seropositive pregnant women.
METHODS:
We performed a nested case control study within a perinatal cohort in Nairobi, Kenya. Herpes simplex virus type 2 serostatus and the presence of genital ulcers were ascertained at 32 weeks of gestation. Maternal cervical and plasma HIV-1 RNA and cervical HSV DNA were measured at delivery.
RESULTS:
One hundred fifty-two (87%) of 175 HIV-1-infected mothers were HSV-2-seropositive. Among the 152 HSV-2-seropositive women, nine (6%) had genital ulcers at 32 weeks of gestation, and 13 (9%) were shedding HSV in cervical secretions. Genital ulcers were associated with increased plasma HIV-1 RNA levels (P=.02) and an increased risk of intrapartum HIV-1 transmission (16% of transmitters versus 3% of nontransmitters had ulcers; P = .003), an association which was maintained in multivariable analysis adjusting for plasma HIV-1 RNA levels (P=.04). We found a borderline association for higher plasma HIV-1 RNA among women shedding HSV (P=.07) and no association between cervical HSV shedding and either cervical HIV-1 RNA levels or intrapartum HIV-1 transmission (P=.4 and P=.5, [corrected] respectively).
CONCLUSION:
Herpes simplex virus type 2 is the leading cause of genital ulcers among women in sub-Saharan Africa and was highly prevalent in this cohort of pregnant women receiving prophylactic zidovudine. After adjusting for plasma HIV-1 RNA levels, genital ulcers were associated with increased risk of intrapartum HIV-1 transmission. These data suggest that management of HSV-2 during pregnancy may enhance mother-to-child HIV-1 prevention efforts.
LEVEL OF EVIDENCE:
II | en |
dc.language.iso | en | en |
dc.title | Herpes simplex virus type 2 and risk of intrapartum human immunodeficiency virus transmission. | en |
dc.type | Article | en |
local.publisher | Departments of Epidemiology and Medicine, University of Washington, | en |
local.publisher | Department of Pediatrics, University of Nairobi, | en |