Prevalence, Incidence and Risk Factors for Herpes Simplex Virus Type 2 Infection in Cohorts of Factory Workers, Akaki and Wonji, Ethiopia, 1997-2002
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Date
2003-05
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Addis Ababa University
Abstract
Retrospective cohort study (1997-2002) was conducted to determine the prevalence, incidence and risk factors for Herpes simplex virus type 2 (HSV-2) infections among factory workers at two sites in Ethiopia. Among enrolled participants in a cohort study of HIV incidence and disease progression, 1222 (71.3%) were males and 491 (28.7%) were females. The median age was 35 years for males (range, 19-62) and 33 years (range, 19-46) for females. The serologic status of each stored plasma sample for HIV and syphilis has been
routinely determined. Antibody to HSV-2 was detected by using the HerpeSelect TM 2 ELISA IgG, Focus Technologies, USA. The HSV-2 prevalence at enrollment was 41.1%, 57.2% among females and 34.6% among males (p<0.001). Seventeen-percent of females and 9.7% of males younger than 25 years had evidence of HSV-2 infection. Independent risk factors for HSV-2 seropositivity were HIV seropositivity, positive TPPA serology, older age, female sex, and ever being married. The incidence of HSV-2 during follow-up was 1.2/100 person-years (95%CI, 1.0-1.4), 2/100 person-years (95% CI, 1.2-3.2) among females and 0.9/100 personyears (95%CI, 0.7-1.3) among males (p=0.02, assuming Poisson distribution). Positive HIV serology at enrollment was an independent risk factor for HSV-2 seroconversion (adjusted hazard ratio [HR], 2.5; 95% CI, 1.1-5.6). Most of HSV-2 infections were asymptomatic or had minor symptoms, which were not recognized. The study showed high prevalence and incidence of HSV-2 infection. This large number of herpes infected individuals may continue
to engage in unprotected sexual activity despite their infection facilitating the sexual transmission of HSV-2 and HIV making the vicious cycle. In the absence of protective vaccine or effective antiviral therapy, prevention of HSV-2 infection will rely on the widespread use of condoms and reduction in the number of sexual partners with emphasis to prevention of HSV-2 infection at early ages.
Key words: HSV-2, incidence, prevalence, seroconversion, Ethiopia
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Keywords
HSV-2, Incidence, Prevalence, Seroconversion