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Effect of HSV-2 serostatus on acquisition of HIV by young men: results of a longitudinal study in Orange Farm, South Africa.
Sobngwi-Tambekou J., Taljaard D., Lissouba P., Zarca K., Puren A., Lagarde E., Auvert B.
The Journal of Infectious Diseases 199, 7 (2009) 958-64 - http://www.hal.inserm.fr/inserm-00375883
 (19220143) 
Effect of HSV-2 serostatus on acquisition of HIV by young men: results of a longitudinal study in Orange Farm, South Africa.
Joelle Sobngwi-Tambekou1, Dirk Taljaard2, Pascale Lissouba1, Kevin Zarca1, Adrian Puren3, Emmanuel Lagarde4, Bertran Auvert () 1, 5, 6
1:  Santé publique et épidémiologie des déterminants professionnels et sociaux de la santé
http://www.u687.idf.inserm.fr/
INSERM : U687 – IFR69 – Université Paris XI - Paris Sud – Université de Versailles Saint-Quentin-en-Yvelines
Hôpital Paul Brousse 16, av Paul Vaillant Couturier 94807 VILLEJUIF
France
2:  Progressus
Progressus
Johannesburg
South Africa
3:  National Institute for Communicable Disease
National Institute for Communicable Disease
Johannesburg
South Africa
4:  Epidémiologie, santé publique et développement
INSERM : U593 – IFR99 – Université Victor Segalen - Bordeaux II – ISPED
Universite Victor Segalen 146, Rue Leo Saignat 33076 BORDEAUX CEDEX
France
5:  UFR médicale
Université de Versailles Saint-Quentin-en-Yvelines
Garches, F-92340
France
6:  Hôpital Ambroise Paré
Université de Versailles Saint-Quentin-en-Yvelines – Assistance publique - Hôpitaux de Paris (AP-HP)
9, avenue Charles-de-Gaulle 92100 Boulogne
France
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.
Life Sciences/Health Care Sciences and Epidemiology
English
0022-1899

Article in peer-reviewed journal
10.1086/597208
The Journal of Infectious Diseases
international
2009-04-01
199
7
958-64

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