Prevalence and risk factors of HSV-1 and HSV-2 antibodies in European HIV infected women

Objectives: To investigate the prevalence and risk factors of HSV-1 and HSV -2 antibodies in HIV infected women and the association between recurrent g enital ulcerations and HIV disease progression in HSV-2 positive women. Methods: The presence of HSV antibodies was tested in 276 of the 487 women participating in a European cohort study of HIV infected women. Prevalence rate ratios described the association between HSV infection and its risk fa ctors, using log binomial regression. Generalised estimating equations (GEE ) analysis was performed to determine the impact of markers of HIV disease progression on recurrent: genital ulcerations. Results: The prevalence of HSV-I and HSV-2 antibodies was 76% (95% confiden ce interval (95% CI): 71-81) and 42% (95% CI: 36-50); 30% (95% CI: 24-35) o f the women had antibodies against both HSV-1 and HSV-2. The prevalence of HSV-I was 86% (95% CI: 80-92) in southern Europe compared with 69% (95% CI: 57-79) and 67% (95% CI: 55-77) in central and northern Europe (p=0.002). T his geographical variation remained after adjustment for other risk factors . An increasing number of years of sexual activity (p=0.0002) and a history of prostitution (p=0.0001) were independently associated with HSV-2 preval ence. In HSV-2 positive women, symptomatic cases of HSV infection were mini mal, but increased with decreasing CD4 count. Conclusion: In HIV infected women, the prevalence of HSV antibodies is high and symptomatic cases of HSV infection are minimal, but increase with decr easing CD4 count. HSV-2 but not HSV-1 was related to sexual behaviour (thar is, a history of prostitution and the number of sexually active years) in this group of HIV infected women.