Effect of HSV-2 serostatus on acquisition of HIV by young men: results of a longitudinal study in Orange Farm, South Africa.
Open accessAbstract
BACKGROUND: The objectives of this study were to assess the impact among young men of herpes simplex virus type 2 (HSV-2) status on the acquisition of human immunodeficiency virus (HIV) and on the protective effect of male circumcision against HIV acquisition. METHODS: We used data collected during a male circumcision trial conducted in Orange Farm, South Africa. We estimated adjusted incidence rate ratios (IRRs) for HIV acquisition, using survival analysis and background characteristics, HSV-2 status, male circumcision status, and sexual behavior as covariates. RESULTS: Compared with subjects who remained HSV-2 negative throughout the study, subjects who were HSV-2 positive at enrollment had an adjusted IRR of 3.3 (95% confidence interval [CI], 1.5-7.4; P=.004), and those who became HSV-2 positive during follow-up had an adjusted IRR of 7.0 (95% CI, 3.9-12.4; P<.001). The population fraction of incident HIV infection attributable to HSV-2 was 27.8% (95% CI, 17.7%-37.2%). Intention-to-treat analysis of the protective effect of male circumcision on HIV acquisition was the same among men with and men without HSV-2 (0.38 vs. 0.37; P=.93). CONCLUSIONS: This study shows that HSV-2 has a substantial impact on HIV acquisition among young South African men. It suggests that HSV-2 infection enhances HIV acquisition and is responsible for approximately 25% of incident cases of HIV infection. However, the protective effect of male circumcision against HIV acquisition appears independent of HSV-2 serostatus. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT00122525.
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In those trials, circumcision also was protective against other STIs, including high-risk genital HPV infection and genital herpes.
“In those trials, circumcision also was protective against other STIs, including high-risk genital HPV infection and genital herpes (66–68).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [68]
The Results (Risk factors of HSV-2 incidence; page unavailable) report a protective effect of circumcision against HSV-2 acquisition in young men, significant in the as-treated analysis but only borderline in the intention-to-treat analysis. The paper does not report an effect on high-risk genital HPV infection, so it supports the genital-herpes portion of the sentence but not the HPV portion. (LLM, conf=0.87)
Experimental — accuracy not yet measuredMMC can be associated with decreased risk for HSV-2 acquisition among adult heterosexual men and with decreased risk for HSV-2 transmission from male to female partners.
“These data indicate that MMC can be associated with decreased risk for HSV-2 acquisition among adult heterosexual men and with decreased risk for HSV-2 transmission from male to female partners.”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [68]
The Discussion reports a protective association between male circumcision and HSV-2 acquisition in young men, significant in the as-treated analysis but not the intention-to-treat analysis. It does not report reduced HSV-2 transmission from men to female partners; it discusses female-to-male transmission instead. No page numbers are provided in our copy. (LLM, conf=0.90)
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- Authors
- Sobngwi‐Tambekou, J., Taljaard, D., Lissouba, P., Zarca, K., Puren, A., Lagarde, E., & Auvert, B.
- Affiliations
- Inserm (FR)
- National Institute for Communicable Diseases (ZA)
- Venue
- The Journal of Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2009-04
- Volume
- 199
- Issue
- 7
- Pages
- 958-964
- ISSN
- 0022-1899 (ISSN-L)
- 1537-6613
- PMC
- PMC2868899
- OpenAlex
- W2109780373
- Cited by
- 142
- References
- 37
- Citations by year
- 2026: 1 · 2024: 2 · 2023: 1 · 2022: 5 · 2021: 3 · 2020: 5 · 2019: 3 · 2018: 2 · 2017: 12 · 2016: 10 · 2015: 9 · 2014: 12 · 2013: 15 · 2012: 14
- FWCI
- 13.94
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- HAL (submittedVersion, other-oa)
- Funders
- Bill and Melinda Gates Foundation (33759)
- Institut National de la Santé et de la Recherche Médicale
- Topics
- Health Sciences › Medicine › Epidemiology › Herpesvirus Infections and Treatments
- Health Sciences › Medicine › Surgery › Genital Health and Disease
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Keywords
- HIV acquisition, herpes simplex virus type 2, male circumcision, HIV prevention, young men, sexual behavior, attributable fraction
- MeSH terms
- Adolescent, Antibodies, Viral, Circumcision, Male, Herpes Genitalis, Humans, Longitudinal Studies, Male, Risk Factors, South Africa, HIV-1, HIV Infections, Incidence, Herpesvirus 2, Human, Young Adult
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