Seroprevalence of Co-Infection of HSV-2 and HIV in Clients attending VCT at The University Teaching Hospital

Abstract

The main objectives of this study are to explore the seroprevalence of co-infection of Human immunodeficiency virus and Herpes Simplex Virus-2 in clients attending voluntary counselling and testing (VCT), seroprevalence of HSV-2 among HIV negative and HIV positive and to determine associations between demographic and sexual behaviour factors on one hand and co-infection on the other.This was a descriptive study that was conducted at University Teaching Hospital in clinic 3. This clinic is a Sexually Transmitted Infections clinic which also has VCT services. The study was conducted on clients who were attending VCT for a period of three months.Clients attending VCT were asked to complete a VCT standard and a HSV-2 questionnaires. In the HSV-2 questionnaire, clients were asked questions about demographic and sexual behavioural factors. These clients were between 18 and 49 years old. For each client who gave consent, 4 millilitres of venous blood was collected once for HIV and HSV-2 tests. For testing HIV Abbott determine was used (screening test) with a sensitivity of 100% and specificity of 99.7%. The Uni-Gold test was used for confirmatory testing with sensitivity of 100% and specificity of 100%. For HSV-2 testing, indirect ELISA IgG which has the sensitivity of 99.4% and specificity of 98% was used.Before getting results, clients were also given post test counselling. Those who were found seropositive for both or either of the two viruses were referred to clinicians for management.The co-infection rate among clients attending VCT was 17.9% (41/229). The seroprevaence of HSV-2 among HIV positive clients was 59.4% (41/69) compared to seroprevalence of HSV-2 among those who were HIV negative of 13.7% (22/160). The sex distribution was significantly different between males and females (p = 0.029). Females were more likely to be co-infected than males. No age difference was observed between the two age groups those aged 18 to 34 and those between 35 and 49 years old. There was association between condom use and the co-infection (X^ 11.00; p value 0.004), while multiple sex partners yielded no significant association (p= 0.234). Those clients who reported with history of sexually transmitted infections were more likely to be co-infected than those who reported no history of sexually transmitted infections. The level of education showed no significant association with co-infection. Condom use, history of sexually transmitted infections and sex were all statistically significantly associated with co-infection. Those clients who reported non condom use, history of STIs and females were more likely to be co-infected. There was no significant different between educational level and co-infection as well as multiple sex partners and co-infection in this study.According to our results, we need to screen for HSV-2 in clients attending VCT because HSV-2 is also common in these clients. We also need counselling for both HIV and HSV-2 due to the fact that there is likehood of co-infection. There is need for more health promotion about condom use to prevent infection as reported elsewhere to reduce both HIV and HSV-2 infections. More research needs to be done in order to get more information on the screening for HSV-2 in VCT centres.