herpes simplex virus type 2, genital ulcers and hiv-1 disease progression in postpartum women单纯疱疹病毒2型、生殖器溃疡和hiv - 1在产后妇女疾病进展.pdfVIP

Herpes Simplex Virus Type 2, Genital Ulcers and HIV-1 Disease Progression in Postpartum Women 1 2 1,2,3 4 5 Alison C. Roxby *, Alison L. Drake , Grace John-Stewart , Elizabeth R. Brown , Daniel Matemo , Phelgona A. Otieno6, Carey Farquhar1,2,3 1 Department of Medicine, University of Washington, Seattle, Washington, United States of America, 2 Department of Global Health, University of Washington, Seattle, Washington, United States of America, 3 Department of Epidemiology, University of Washington, Seattle, Washington, United States of America, 4 Department of Biostatistics, University of Washington, Seattle, Washington, United States of America, 5 Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya, 6 Centre for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya Abstract Background: Co-infection with herpes simplex virus type 2 (HSV-2) has been associated with increased HIV-1 RNA levels and immune activation, two predictors of HIV-1 progression. The impact of HSV-2 on clinical outcomes among HIV-1 infected pregnant women is unclear. Methods: HIV-1 infected pregnant women in Nairobi were enrolled antenatally and HSV-2 serology was obtained. HIV-1 RNA and CD4 count were serially measured for 12–24 months postpartum. Survival analysis using endpoints of death, opportunistic infection (OI), and CD4,200 cells mL, and linear mixed models estimating rate of change of HIV-1 RNA and CD4, were used to determine associations between HSV-2 serostatus and HIV-1 progression. Results: Among 296 women, 254 (86%) were HSV-2-seropositive. Only 30 (10%) women had prior or current genital ulcer disease (GUD); median baseline CD4 count was 422 cells mL. Adjust