Global population-level association between herpes simplex virus 2 prevalence and HIV prevalence. (19th June 2018)

• Record Type: Journal Article
• Authors: Kouyoumjian, Silva P.; Heijnen, Marieke; Chaabna, Karima; Mumtaz, Ghina R.; Omori, Ryosuke; Vickerman, Peter; Abu-Raddad, Laith J.
• Is Part Of: AIDS. Volume 32:Number 10(2018)
• Publication Date: 2018-06-19
• Subjects: epidemic potential -- epidemiologic overlap -- meta-analysis -- sexually transmitted infection -- systematic review; AIDS (Disease) -- Periodicals; Acquired Immunodeficiency Syndrome; AIDS (Disease); Periodicals; Periodicals; 616.9792005
• DOI: 10.1097/QAD.0000000000001828
• Languages: English
• ISSNs: 0269-9370

Abstract

Abstract : Background: Our objective was to assess the population-level association between herpes simplex virus 2 (HSV-2) and HIV prevalence. Methods: Reports of HSV-2 and HIV prevalence were systematically reviewed and synthesized following PRISMA guidelines. Spearman rank correlation ( ) was used to assess correlations. Risk ratios (RRHSV-2/HIV ) and odds ratios (ORHSV-2/HIV ) were used to assess HSV-2/HIV epidemiologic overlap. DerSimonian–Laird random-effects meta-analyses were conducted. Results: In total, 939 matched HSV-2/HIV prevalence measures were identified from 77 countries. HSV-2 prevalence was consistently higher than HIV prevalence. Strong HSV-2/HIV prevalence association was found for all data ( = 0.6, P < 0.001), all data excluding people who inject drugs (PWID) and children ( = 0.7, P < 0.001), female sex workers ( = 0.5, P < 0.001), and MSM ( = 0.7, P < 0.001). No association was found for PWID ( = 0.2, P = 0.222) and children ( = 0.3, P = 0.082). A threshold effect was apparent where HIV prevalence was limited at HSV-2 prevalence less than 20%, but grew steadily with HSV-2 prevalence for HSV-2 prevalence greater than 20%. The overall pooled mean RRHSV-2/HIV was 5.0 (95% CI 4.7–5.3) and ORHSV-2/HIV was 9.0 (95% CI 8.4–9.7). The RRHSV-2/HIV and ORHSV-2/HIV showed similar patterns that conveyed inferences about HSV-2 and HIV epidemiology. Conclusion: HSV-2 and HIV prevalence are strongly associated. HSV-2 prevalence can be used as a proxy 'biomarker' of HIV epidemic potential, acting as a 'temperature scale' of the intensity of sexual risk behavior that drive HIV transmission. HSV-2 prevalence can be used to identify populations and/or sexual networks at high-risk of future HIV expansion, and help prioritization, optimization, and resource allocation of cost-effective prevention interventions. Abstract : Supplemental Digital Content is available in the text