Abstract
Herpes simplex virus type 2 (HSV-2) acquired during pregnancy is associated with adverse outcomes such as perinatal HSV-2 transmission. HSV-2 seroconversion occurs within four weeks of HSV-2 acquisition. There was neither documented incidence nor risk factors for HSV-2 seroconversion during pregnancy in Uganda. The objective of this study was to determine the incidence and risk factors for HSV-2 seroconversion among pregnant women in Mulago Hospital, Uganda. A prospective study of 200 consenting HSV-2-negative women between 26 and 28 weeks of gestation was done between November 2013 and October 2014. HSV-2 serostatus was determined using HerpeSelect HSV-2 enzyme-linked immunosorbent assay (ELISA). Interviewer-administered questionnaires were used to collect socio-demographic characteristics and sexual history. Human immunodeficiency virus (HIV) serostatus was obtained from antenatal records. A total of 191 women completed follow-up and repeat HSV-2 serology by 38 weeks. Negative binomial regression analysis was used to estimate risk ratios for risk factors for HSV-2 seroconversion. Of 191 women, 15 (7.9%) seroconverted during pregnancy. Having multiple sexual partners, being in polygamous unions, and having HIV-positive serostatus were found to be risk factors for HSV-2 seroconversion. The incidence of HSV-2 seroconversion during pregnancy in Uganda was high. Multiple sexual partners, polygamy, and HIV-positive serostatus were risk factors for HSV-2 seroconversion during pregnancy. Strengthening health education on the avoidance of multiple sexual partners during pregnancy is paramount in prevention of HSV-2 seroconversion.
Highlights
Herpes simplex virus type 2 (HSV-2) acquired during pregnancy is associated with adverse outcomes such as perinatal HSV-2 transmission
Women who had multiple sexual partners in the preceding six months and women in polygamous marriages were at increased risk of HSV-2 seroconversion (RR: 4.53; 95% CI: 1.51–13.50) and (RR: 6.31; 95% CI: 2.09–19.0), respectively
HSV-2 seroconversion was associated HIVpositive status (RR: 5.72; 95% CI: 2.00–16.32) but was not associated with Trichomonas vaginalis (RR: 3.11; 95% CI, 0.82–11.76) or candidiasis (RR: 1.42; 95% CI: 0.53–3.84)
Summary
Herpes simplex virus type 2 (HSV-2) acquired during pregnancy is associated with adverse outcomes such as perinatal HSV-2 transmission. There was neither documented incidence nor risk factors for HSV-2 seroconversion during pregnancy in Uganda. The objective of this study was to determine the incidence and risk factors for HSV-2 seroconversion among pregnant women in Mulago Hospital, Uganda. Having multiple sexual partners, being in polygamous unions, and having HIV-positive serostatus were found to be risk factors for HSV-2 seroconversion. Polygamy, and HIVpositive serostatus were risk factors for HSV-2 seroconversion during pregnancy. Genital herpes simplex type 2 (HSV-2) is a sexually transmitted DNA virus and is prevalent in many geographical areas, especially among women 15–49 years of age [1]. The HSV-2 prevalence was 67.2% among pregnant women in Uganda, and was even higher (86%) among pregnant women who were human immunodeficiency virus (HIV) seropositive [6].
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