Incidence and predictors of sexually transmitted infections among adult HIV-positive patients receiving antiretroviral therapy at Themba Lethu HIV clinic in Johannesburg, South Africa

Onoya, Dorina; Manjengwa, P; Nattey, Cornelius; Kgowedi, Sharon; Mbele, Mzwandile; Shumba, Khumbo; Fox, Matthew P.

doi:10.7196/samj.2020.v111i1.14672

Cited by 3 publications

(4 citation statements)

References 9 publications

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“…In sub-Saharan Africa, a moderate number of studies 17–19 have reported a high HSV-2 seroprevalence among WLHIV, with an estimated 93.3% prevalence reported in KwaZulu-Natal, South Africa 19 where this study was conducted. We found two studies in South Africa that performed diagnostic testing to determine active HSV-2 infection prevalence of 10.8% in WLHIV 10 and 13.7% 9 in PLHIV. However, few studies have determined the incidence and predictors of HSV-2 PCR positivity among PLHIV in sub-Saharan Africa.…”

Section: Discussionmentioning

confidence: 99%

“…5 Among women living with HIV (WLHIV), the risk of HSV-2 infection 5,6 and HSV-2 shedding at the vaginal mucosa 7 are higher than in HIV-negative women. In South Africa, a global hotspot of the HIV epidemic, 8 two studies have estimated 13.7% prevalence of HSV-2 in men and women living with HIV 9 and 10.8% prevalence in WLHIV. 10 In WLHIV, HSV-2 coinfection with HIV causes increased morbidity through prolonged genital herpes recurrences, especially among patients with lower immune status.…”

Section: Introductionmentioning

confidence: 99%

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Incidence of herpes simplex virus type 2 positivity among women living with human immunodeficiency virus in South Africa

Asare,

Ngcapu,

Osman

et al. 2023

Int J STD AIDS

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Background For women living with HIV (WLHIV), co-infection with herpes simplex virus type 2 (HSV-2) causes severe genital ulcers and presents additional challenges for their HIV care. To inform preventive strategies, we aimed to determine the incidence and risk factors of HSV-2 positivity in a prospective cohort of South African women. Methods The CAPRISA 002 study enrolled women at acute HIV infection between 2004 and 2020. HSV-2 testing was conducted by multiplex polymerase chain reaction (PCR) assay on collected vaginal swabs up to twice annually during follow-up. We calculated incidence as the number of new cases per 100 person-years (PYs) and used Cox-proportional-hazard regression to identify factors associated with time-to-HSV-2 PCR positivity. Results At enrolment, the median age of 171 women was 24 years, interquartile range (IQR 21–28), and the estimated median days since HIV infection was 42 (IQR 22–65). Of participants tested at enrolment, HSV-2 antibody prevalence was 81.4% (105/129), and 10.6% (12/113) were positive by PCR. Among 147 women with a prior negative HSV-2 PCR diagnosis, we observed 47 new HSV-2 PCR positive cases over 424.4 PYs of follow-up, yielding an incidence rate of 11.1 cases per-100-PYs. HSV-2 PCR positivity incidence was higher among younger women (<25 years: adjusted Hazard Ratio [aHR] = 5.91, 95%CI 3.02–11.6), those with bacterial vaginosis (BV) (Nugent score 7–10: aHR = 2.17, 95%CI 1.15–4.10) and lower CD4 counts (<500 cells/μl: aHR = 2.04, 95%CI 1.08–3.87). Conclusion After acute HIV infection in women, the incidence of HSV-2 PCR positivity was associated with younger age, BV diagnosis and lower CD4 count.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Incidence of herpes simplex virus type 2 positivity among women living with human immunodeficiency virus in South Africa

Asare,

Ngcapu,

Osman

et al. 2023

Int J STD AIDS

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“…In developing countries such as South Africa, sexually transmitted infections (STIs) are an important public health concern [1], enhanced by Human Immunodeficiency Virus (HIV) transmission, cardiovascular complications and severe neurological disability if not managed appropriately [2].…”

Section: Introductionmentioning

confidence: 99%

Oral Manifestations of Syphilis: Report of Four Cases

et al. 2022

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Syphilis is an infectious disease caused by Treponema pallidum. Syphilis can present with an array of oral manifestations at different stages of disease progression. This article reports on four cases of syphilis with oral manifestations diagnosed by oral health professionals. Case 1: 18-year-old female presented with multiple ulcerations and patches involving the hard palate, uvula, retromolar area, and papillary nodules on the tongue. Case 2: 25-year-old male presented with a solitary, exophytic lesion on the anterior tongue. Case 3: 17-year-old female presented with multiple pigmented macules on the palms of hands and soles of feet, as well as multiple exophytic, sessile, soft tissue masses throughout the oral cavity. Case 4: 14-year-old female presented with a solitary, exophytic, verrucous lesion in the incisive papilla area, as well as multiple, coalescing patches involving the soft palate, uvula, and tonsillar areas. All patients were managed by biopsy and serological investigations. Treatment of syphilis was performed at infectious disease clinics with 2.4 million units (MUs) benzathine benzylpenicillin intramuscular (IM) weekly. Oral health professionals need to have knowledge of the oral manifestations of syphilis to ensure that patients are accurately identified and appropriately treated.

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“…29 The syndromic STI management approach is beneficial, but it limits the opportunities for diagnosing asymptomatic STIs. 9,30 Syndromic STI management is the diagnosis of STIs based on symptoms and signs, which subsequently leads to their treatment, with point-of-care therapies to treat the majority of microbes that produce specific syndromes without confirmation with the laboratory tests. 31 It was introduced into South African primary healthcare in 1995; despite this introduction, the burden of STIs remains high.…”

Section: Introductionmentioning

confidence: 99%

Aetiology of genital ulcer disease and associated factors among Mthatha public clinic attendees

Tshaka

Singh

Apalata

et al. 2022

Southern African Journal of Infectious Diseases

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Background: Genital ulcer disease (GUD) is a sexually transmitted disease characterised by ulcerating lesions. Despite the introduction of sexually transmitted infections (STIs) syndromic management approach into primary healthcare in South Africa (SA) in 1995, the prevalence of STIs in South Africa remains high.Objectives: The study investigated the aetiology of GUD and factors influencing it among public community health centre (CHC) attendees in the Eastern Cape, South Africa.Method: A total of 105 participants were recruited among individuals presenting with GUD from three CHCs located in the Eastern Cape Province, South Africa. Blood and genital ulcer samples were collected from consented participants. Blood samples with suitable sera were tested for human immunodeficiency virus (HIV) and syphilis. Herpes simplex virus types 1/2 (HSV–1/2), Chlamydia trachomatis, Treponema pallidum, Haemophilus ducreyi and Klebsiella granulomatis were detected in nucleic acid extracted from genital ulcer specimens.Results: Out of the 98 samples with suitable sera, 55.1% and 8.2% were HIV and syphilis seropositive, respectively. Ulcerating STI pathogens were detected in 31.4% of the study participants. Herpes simplex virus type 2 was the most detected pathogen (16.2%) followed by Chlamydia trachomatis (10.5%), HSV-1 (8.6%), Haemophilus ducreyi (8.6%) and Treponema pallidum (6.7%). Multiple pathogens were detected in 13.3% of participants. Detected multiple ulcerating pathogens were common among HIV-positives (p = 0.016).Conclusion: Molecular methods for diagnosing pathogens have the potential to improve the management of GUD. Data generated from this study would contribute to the limited data on GUD in the Eastern Cape Province. Further research with a larger sample size is recommended.Contribution: Data generated would contribute to the limited data on GUD in the Eastern Cape province, South Africa.

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Incidence and predictors of sexually transmitted infections among adult HIV-positive patients receiving antiretroviral therapy at Themba Lethu HIV clinic in Johannesburg, South Africa

Cited by 3 publications

References 9 publications

Incidence of herpes simplex virus type 2 positivity among women living with human immunodeficiency virus in South Africa

Incidence of herpes simplex virus type 2 positivity among women living with human immunodeficiency virus in South Africa

Oral Manifestations of Syphilis: Report of Four Cases

Aetiology of genital ulcer disease and associated factors among Mthatha public clinic attendees

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