The prevalence, incidence and risk factors of herpes simplex virus type 2 infection among pregnant Zimbabwean women followed up nine months after childbirth

Abstract

BackgroundHerpes simplex virus type 2 (HSV-2) is the leading cause of genital ulcer disease worldwide. The virus can be transmitted to neonates and there are scarce data regarding incidence of HSV-2 among women in pregnancy and after childbirth. The aim of this study is to measure the incidence and risk factors for HSV-2 infection in women followed for 9 months after childbirth.MethodsPregnant women were consecutively enrolled late in pregnancy and followed at six weeks, four and nine months after childbirth. Stored samples were tested for HSV-2 at baseline and again at nine months after childbirth and HSV-2 seropositive samples at nine months after childbirth (seroconverters) were tested retrospectively to identify the seroconversion point.ResultsOne hundred and seventy-three (50.9%) of the 340 consecutively enrolled pregnant women were HSV-2 seronegative at baseline. HSV-2 incidence rate during the 10 months follow up was 9.7 (95% CI 5.4-14.4)/100 and 18.8 (95% CI 13.9-26.1)/100 person years at risk (PYAR) at four months and nine months after childbirth respectively. Analysis restricted to women reporting sexual activity yielded higher incidence rates. The prevalence of HSV-2 amongst the HIV-1 seropositive was 89.3%. Risk factors associated with HSV-2 seropositivity were having other sexual partners in past 12 months (Prevalence Risk Ratio (PRR) 1.8 (95% CI 1.4-2.4) and presence of Trichomonas vaginalis (PRR 1.7 95% CI 1.4-2.1). Polygamy (Incidence Rate Ratio (IRR) 4.4, 95% CI 1.9-10.6) and young age at sexual debut (IRR 3.6, 95% CI 1.6-8.3) were associated with primary HSV-2 infection during the 10 months follow up.ConclusionsIncidence of HSV-2 after childbirth is high and the period between late pregnancy and six weeks after childbirth needs to be targeted for prevention of primary HSV-2 infection to avert possible neonatal infections.

Incidence and risk factors for herpes simplex virus type 2 seroconversion among pregnant women in Uganda: A prospective study

“…Having multiple sexual partners or sex with a person who has multiple partners and young age of sexual debut were significantly associated with HSV-2 acquisition [1,5]. In addition, having any sexually transmitted diseases was a risk factor for HSV-2 seroconversion [8,12].…”

“…HIV-positive women were five times more likely to have HSV-2 infection than were HIV-negative women in Mulago Hospital. However, in a study by Munjoma et al (2009), HIV serostatus was not found to be a risk factor for HSV-2 seroconversion in pregnancy [5]. There is a need to further explore a possible association between HIV and HSV-2 seroconversion.…”

“…In Italy, the incidence of HSV-2 acquisition in pregnancy was 3.0% [1]. In Zimbabwe, the seroconversion incidence was 4.2% (7/167) between the last four weeks of pregnancy and four months after childbirth [5].…”

“…The HSV-2 seroprevalence among women of childbearing age in developed countries ranges from 10.0%-40.0% compared to 30%-80% in developing countries [2][3][4]. The prevalence of HSV-2 among pregnant women in Zimbabwe was 49.1% [4,5]. In Uganda, the HSV-2 seroprevalence among women in the general population was 49.0%.…”

Prevalence of HSV1 and HSV2 among HIV Patients in Northern South Africa as Determined by Real Time PCR in Urine Samples

“…In the same study done by Bernstein et al (2012) in America, the prevalence of HSV-1 was 3.6% in patients with genital warts which was very low compared to the present study in which 54.5% of HSV-1 patients also had genital warts. In Tanzania, Msuya et al (2009) obtained a prevalence of 1.1% in HIV positive patients who had genital warts (Munjoma et al, 2010). Different methodological approaches may have different significance.…”