Global population-level association between herpes simplex virus 2 prevalence and HIV prevalence

Silva P. Kouyoumjian, Marieke Heijnen, Karima Chaabna, Ghina R. Mumtaz, Ryosuke Omori, Peter Vickerman, Laith J. Abu-Raddad

Research output: Contribution to journalArticle

4 Citations (Scopus)

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 (RR HSV-2/HIV) and odds ratios (OR HSV-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 RR HSV-2/HIV was 5.0 (95% CI 4.7-5.3) and OR HSV-2/HIV was 9.0 (95% CI 8.4-9.7). The RR HSV-2/HIV and OR HSV-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.

Original languageEnglish
Pages (from-to)1343-1352
Number of pages10
JournalAIDS
Volume32
Issue number10
DOIs
Publication statusPublished - 19 Jun 2018

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Keywords

  • epidemic potential
  • epidemiologic overlap
  • meta-Analysis
  • sexually transmitted infection
  • systematic review

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

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