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Title Transmission probabilities of HIV and herpes simplex virus type 2, effect of male circumcision and interaction: a longitudinal study in a township of South Africa.
Full text http://www.hal.inserm.fr/docs/00/37/17/63/PDF/Mahiane_AIDS.pdf
Date 2009
Author(s) Mahiane, Séverin-Guy; Legeai, Camille; Taljaard, Dirk; Latouche, Aurélien; Puren, Adrian; Peillon, Aurélie; Bretagnolle, Jean; Lissouba, Pascale; Ndong Nguéma, Eugène-Patrice; Gassiat, Elisabeth; Auvert, Bertran
Abstract OBJECTIVES: A synergy between HIV and herpes simplex virus type 2 (HSV-2) infections has been reported in observational studies. The objectives of this study were to estimate the per-sex-act female-to-male transmission probabilities (FtoMTPs) of HIV and HSV-2, the effect of each infection on the FtoMTP of the other and the effect of male circumcision on these FtoMTPs. DESIGN: We used longitudinal data collected during the male circumcision trial conducted in Orange Farm (South Africa). METHODS: Results were obtained by specific mathematical modeling of HIV and HSV-2 statuses of the men as functions of their sexual behavior and male circumcision status. The model took into account an estimation of the HIV and HSV-2 statuses of each of their female partners. Confidence intervals (CI) were estimated using a bootstrap resampling method. RESULTS: The HIV and HSV-2 FtoMTPs, during an unprotected sexual contact for an uncircumcised male in the absence of the other virus in both partners, were 0.0047 (95% CI: 0.0014-0.017) and 0.0067 (95% CI: 0.0028-0.014), respectively. HSV-2 in either partner increased HIV FtoMTP with a relative risk (RR) of 3.0 (95% CI: 1.01-7.3). Conversely, HIV in either partner increased HSV-2 FtoMTP (RR= 2.5; 95% CI: 1.1- 6.3). Male circumcision significantly decreased these probabilities with RRs of 0.24 (95% CI: 0.11-0.44) and 0.59 (95% CI: 0.36-0.91), respectively. CONCLUSION: This study gave the first estimates of HSV-2 per-sex-act FtoMTPs in Africa. It demonstrated a synergy between HIV and HSV-2 infections and a protective effect of male circumcision on HSV-2 acquisition by males.
Subject(s) [SDV:SPEE] Life Sciences/Health Care Sciences and Epidemiology; HSV-2; HIV; male circumcision; mathematical modeling; heterosexual transmission
Language EN
Publisher HAL - CCSD
Type of publication text
Identifier HAL:inserm-00371763, version 1; HAL:http://www.hal.inserm.fr/inserm-00371763/en/; PUBMED:19198042
Repository France - Hyper Article en Ligne (HAL)
Added to C-A: 2010-04-22;10:41:19