Prevalence and Characteristics of Herpes Simplex Virus Type-2 Coinfection in Veterans With Hepatitis C
ABSTRACT INTRODUCTION: Epidemiologic links between herpes simplex virus type-2 (HSV-2) and hepatitis C virus (HCV) exist but are poorly characterized. Seroprevalence studies of HSV-2 in veteran populations with chronic HCV infection are lacking. METHODS: The authors reviewed the medical histories and results of the HerpeSelect IgG (Focus Diagnostics, Cypress, CA) of 244 HCV-infected male veterans engaged in care. All patients were human immunodeficiency virus negative and >99% defined themselves as heterosexual. RESULTS: Using the manufacturer's recommended cutoff for positive results (>1.1), 51.5% of HCV-infected veterans were seropositive for HSV-2. When increasing the cutoff to >3.5, 38.7% of persons were seropositive for HSV-2. Reports of previous diagnosis with genital ulcer disease (9/213; 4.3%) or genital herpes (4/213; 1.9%) were rare. CONCLUSIONS: HSV-2 infection commonly occurred in the study sample of HCV-infected veterans but was infrequently recognized. Future studies should optimize the use of type-specific serologic screening tests in HCV-infected persons. The high prevalence of HSV-2 in this population merits further investigation into any potential biologic interactions between these common viral infections.
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ABSTRACT: Because many persons with chronic hepatitis C virus (HCV) infection are asymptomatic, population-based serologic studies are needed to estimate the prevalence of the infection and to develop and evaluate prevention efforts. We performed tests for antibody to HCV (anti-HCV) on serum samples from 21,241 persons six years old or older who participated in the third National Health and Nutrition Examination Survey, conducted during 1988 through 1994. We determined the prevalence of HCV RNA by means of nucleic acid amplification and the genotype by means of sequencing. The overall prevalence of anti-HCV was 1.8 percent, corresponding to an estimated 3.9 million persons nationwide (95 percent confidence interval, 3.1 million to 4.8 million) with HCV infection. Sixty-five percent of the persons with HCV infection were 30 to 49 years old. Seventy-four percent were positive for HCV RNA, indicating that an estimated 2.7 million persons in the United States (95 percent confidence interval, 2.4 million to 3.0 million) were chronically infected, of whom 73.7 percent were infected with genotype 1 (56.7 percent with genotype 1a, and 17.0 percent with genotype 1b). Among subjects 17 to 59 years of age, the strongest factors independently associated with HCV infection were illegal drug use and high-risk sexual behavior. Other factors independently associated with infection included poverty, having had 12 or fewer years of education, and having been divorced or separated. Neither sex nor racial-ethnic group was independently associated with HCV infection. In the United States, about 2.7 million persons are chronically infected with HCV. People who use illegal drugs or engage in high-risk sexual behavior account for most persons with HCV infection.New England Journal of Medicine 09/1999; 341(8):556-62. DOI:10.1056/NEJM199908193410802 · 54.42 Impact Factor
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ABSTRACT: The natural history of HSV-2 infection and role of HSV-2 reactivations in HIV disease progression are unclear. Clinical symptoms of active HSV-2 infection were used to classify 1,938 HIV/HSV-2 co-infected participants of the Women's Interagency HIV Study (WIHS) into groups of varying degree of HSV-2 clinical activity. Differences in plasma HIV RNA and CD4+ T cell counts between groups were explored longitudinally across three study visits and cross-sectionally at the last study visit. A dose dependent association between markers of HIV disease progression and degree of HSV-2 clinical activity was observed. In multivariate analyses after adjusting for baseline CD4+ T cell levels, active HSV-2 infection with frequent symptomatic reactivations was associated with 21% to 32% increase in the probability of detectable plasma HIV RNA (trend p = 0.004), an average of 0.27 to 0.29 log10 copies/ml higher plasma HIV RNA on a continuous scale (trend p<0.001) and 51 to 101 reduced CD4+ T cells/mm(3) over time compared to asymptomatic HSV-2 infection (trend p<0.001). HIV induced CD4+ T cell loss was associated with frequent symptomatic HSV-2 reactivations. However, effect of HSV-2 reactivations on HIV disease progression markers in this population was modest and appears to be dependent on the frequency and severity of reactivations. Further studies will be necessary to determine whether HSV-2 reactivations contribute to acceleration of HIV disease progression.PLoS ONE 04/2010; 5(4):e9973. DOI:10.1371/journal.pone.0009973 · 3.53 Impact Factor
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ABSTRACT: The diagnosis of syphilis requires two-step serological testing. Not infrequently, sensitive screening tests are reactive but are not confirmed by more specific confirmatory tests yielding a biological false positive (BFP). This study sought to describe the prevalence of BFP in a large population of hepatitis C virus (HCV)-infected and uninfected women. A cross-sectional serosurvey of HIV-seropositive and HIV-seronegative women enrolled in the Women's Interagency HIV Study, a multicentre collaborative study of the natural history of HIV in women. Among HCV-infected women 4% had a BFP compared with 1% among those who were HCV uninfected (odds ratio (OR) 3.3, 95% CI 2.1 to 5.1). Controlling for both HIV infection and a history of intravenous drug use among all tests for syphilis a BFP also occurred more commonly in HCV-infected women compared with HCV-uninfected women (6% vs 1%, OR 7.62, 95% CI 1.9 to 12.5). HCV infection is associated with various effects on immune function including alterations in serological test results. Women with HCV are more likely to have a BFP syphilis test than women without HCV.Sexually transmitted infections 04/2010; 86(2):97-8. DOI:10.1136/sti.2009.040360 · 3.08 Impact Factor