Abstract
Background Human herpesvirus (HHV) infections can significantly increase the risk of human immunodeficiency virus (HIV) transmission and accelerate disease progression. In the population at high risk of HIV infection, also termed as key populations (female sex workers (FSW), men who have sex with men (MSM), and people who inject drugs (PWID)), and their sexual partners, HHV infections can potentially compromise the efforts to prevent and control HIV infection. Here, we investigated the seroprevalence of HHV infections among HIV-infected key populations in Dar es Salaam, Tanzania. Methodology. We analyzed 262 archived serum samples of HIV-infected key populations from the integrated biobehavioral surveillance (IBBS) study conducted in Dar es Salaam, Tanzania. The enzyme-linked immunosorbent assay was used to determine IgG and IgM titers for cytomegalovirus (CMV) and herpes simplex virus (HSV) types 1 and 2. Results The overall seropositivity of HHV IgG was 92% (95% CI: 87.7–95.3%). HHV IgM was not detected in any of the samples. The most seroprevalent coinfection was CMV at 69.1% (181/262), followed by HSV-2 33.2% (87/262) and HSV-1 32.1% (84/262). HSV-2 infection differed by key population groups; it accounted for FSW (46.3%) (p=0.0001) compared to PWID (21.6%) and MSM (22.7%). In contrast, seroprevalence for CMV and HSV-1 was comparable across the key population groups; whereby, CMV was 62%, 75.3%, and 75% and HSV-1 was 26.4%, 39.2%, and 31.8% for FSW, MSM, and PWID, respectively. We also observed that multiple coinfections with CMV-HSV-2 (p=0.042) and CMV-HSV-1-HSV-2 (p=0.006) were significantly associated with key population aged above 40 years. Conclusion The IgG seroprevalence of CMV, HSV-1, and HSV-2 was high among HIV-positive key populations. These findings indicate that these individuals are prone to recurrence of HHV infections and may harbor replicating viruses that subsequently may affect HIV disease progression. Therefore, this warrants concerted efforts for integrated HIV and sexually transmitted infection prevention programs targeting key populations.
Highlights
human immunodeficiency virus (HIV) key population groups (female sex workers (FSW), men who have sex with men (MSM), and people who inject drugs (PWID)) form a small percentage of people in sub-Saharan Africa (SSA) who are at high risk of HIV infection. e key populations FSW account to 4%, PWID 2%, and MSM 6% of the new infections in SSA [1]
CMV infection is more pronounced in HIV-infected patients and is considered a critical factor in sustaining immune activation. e end outcome links to non-acquired immunodeficiency syndrome (AIDS) complications among subjects on antiretroviral therapy (ART) [10]. e practice of HIV-risk behaviors among key populations exposes them to an increased risk of Human herpesvirus (HHV) infections due to shared routes of transmission [11]. erefore, HIV and HHV coinfection in key populations worsens HIV disease progression and can further fuel HIV transmission to sexual partners, PWID partners, and the general population
This population is suitable for providing baseline data that will be used in further study that intends to assess the association between CMV and non-AIDS complications. e sociodemographic and behavioral characteristics of the participants have been previously reported [12,13,14]. e present study obtained ethical approval from the Institutional Review Board (IRB) of the Muhimbili University of Health and Allied Sciences (MUHAS)
Summary
HIV key population groups (female sex workers (FSW), men who have sex with men (MSM), and people who inject drugs (PWID)) form a small percentage of people in sub-Saharan Africa (SSA) who are at high risk of HIV infection. e key populations FSW account to 4%, PWID 2%, and MSM 6% of the new infections in SSA [1]. HHV infections can significantly increase the risk of HIV transmission and accelerate disease progression [4, 5]. Erefore, HIV and HHV coinfection in key populations worsens HIV disease progression and can further fuel HIV transmission to sexual partners, PWID partners, and the general population. Human herpesvirus (HHV) infections can significantly increase the risk of human immunodeficiency virus (HIV) transmission and accelerate disease progression. In the population at high risk of HIV infection, termed as key populations (female sex workers (FSW), men who have sex with men (MSM), and people who inject drugs (PWID)), and their sexual partners, HHV infections can potentially compromise the efforts to prevent and control HIV infection. Seroprevalence for CMV and HSV-1 was comparable across the key population groups; whereby, CMV was 62%, 75.3%, and 75% and HSV-1 was 26.4%, 39.2%, and 31.8% for FSW, MSM, and PWID, respectively. Conclusion. e IgG seroprevalence of CMV, HSV-1, and HSV-2 was high among HIV-positive key populations. ese findings indicate that these individuals are prone to recurrence of HHV infections and may harbor replicating viruses that subsequently may affect HIV disease progression. erefore, this warrants concerted efforts for integrated HIV and sexually transmitted infection prevention programs targeting key populations
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