Seroprevalence of herpes simplex virus infections among HIV positive individuals in Mbeya region, Tanzania

In Tanzania, HIV and AIDS remains a serious health problem, second only to malaria. Results from the Tanzania Household Indicator Survey for 2007/08 indicate that some 6% of Tanzanians in the age group of 15--49 years were infected with HIV. By 2008, regions that had a high HIV prevalence included Iringa (15.7%), Oar es Salaam (9.3%) followed by Mbeya (9.2%). Synergisms between HSV and HIV have been documented in many studies and that Herpes Simplex Viruses increases the risk of HIV transmission 2 to 3 folds. Despite all that knowledge, the prevalence of HSV infection is largely unknown among HIV positive patients in the general Tanzanian population. Objective To describe the Seroprevalence of Herpes Simplex Virus type 1 and 2 infections among HIV infected individuals in Mbeya region. Materials and Methods This study was conducted in wards of Mbeya region among participants from the ongoing EU funded EMINI project. A specially designed questionnaire was used to identify social and demographic characteristics. Physical examination results were obtained from the database initially collected by NIMR MMRP research nurses and medical officers. Archived participants' sera were tested for Herpes Simplex Virus type 1 and 2 infections using Virotech HSV -1 (gG 1) ELISA (Enzygnost, Behring, Germany) and Kalon HSV -2 (gG2) ELISA (Kalon Biological Ltd, Surrey, UK) respectively. Univariate and multivariate poisson regression models were used to identify factors associated with Herpes Simplex Virus infections. Results A total of 640 adults were randomly recruited after stratification by HIV status, age and sex. The overall Seroprevalence of HSV-1 was 92.1 % while that of HSV-2 was 57.4%. Men and females were equally affected with HSV-1 (94.2% vs. 89.9%) (PR = 1.04, p-value > 0.05) while prevalence of HSV-2 was significantly lower in males as compared to females (64.5% vs. 50.2%) (PR = 0.72, p-value < 0.001). There was a strong and significant trend that HSV-2 increases with age (IRR = 1.18, p-value < 0.001), and HIV status (IRR = 2.05, p-value < 0.001) contrary to HSV-1 findings. HSV-1 was more frequent in hypertensives' (IRR = 1.08, p-value < 0.05) while HSV-2 was more common in over weights and obese participants (IRR = 1.67, p-value < 0.05) Conclusion and Recommendations There is a high prevalence of HSV -2 among females and this coincides with higher number of HIV infection in this group. Considering recent accumulating evidences of interaction of Herpes Simplex Virus infections and HIV; control and suppressive treatment of Herpes Simplex Virus should be considered as a possible strategy to control HIV infection