Transmission probabilities of HIV and herpes simplex virus type 2, effect of male circumcision and interaction: a longitudinal study in a township of South Africa.

Séverin-Guy Mahiane (1) , Camille Legeai (2) , Dirk Taljaard (3) , Aurélien Latouche (4) , Adrian Puren (5) , Aurélie Peillon (6) , Jean Bretagnolle (7) , Pascale Lissouba (6) , Eugène-Patrice Ndong Nguéma (1) , Elisabeth Gassiat (7) , Bertran Auvert (2, 4, 6)

1 ENSPY - Ecole Nationale Supérieure Polytechnique de Yaoundé
2 Hôpital Ambroise Paré [AP-HP]
3 Progressus
4 UVSQ Santé - Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil
5 National Institute for Communicable Disease
6 Santé publique et épidémiologie des déterminants professionnels et sociaux de la santé
7 LM-Orsay - Laboratoire de Mathématiques d'Orsay

OBJECTIVES: A synergy between HIV and herpes simplex virus type 2 (HSV-2) infections has been reported in observational studies. The objectives of this study were to estimate the per-sex-act female-to-male transmission probabilities (FtoMTPs) of HIV and HSV-2, the effect of each infection on the FtoMTP of the other and the effect of male circumcision on these FtoMTPs. DESIGN: We used longitudinal data collected during the male circumcision trial conducted in Orange Farm (South Africa). METHODS: Results were obtained by specific mathematical modeling of HIV and HSV-2 statuses of the men as functions of their sexual behavior and male circumcision status. The model took into account an estimation of the HIV and HSV-2 statuses of each of their female partners. Confidence intervals (CI) were estimated using a bootstrap resampling method. RESULTS: The HIV and HSV-2 FtoMTPs, during an unprotected sexual contact for an uncircumcised male in the absence of the other virus in both partners, were 0.0047 (95% CI: 0.0014-0.017) and 0.0067 (95% CI: 0.0028-0.014), respectively. HSV-2 in either partner increased HIV FtoMTP with a relative risk (RR) of 3.0 (95% CI: 1.01-7.3). Conversely, HIV in either partner increased HSV-2 FtoMTP (RR= 2.5; 95% CI: 1.1- 6.3). Male circumcision significantly decreased these probabilities with RRs of 0.24 (95% CI: 0.11-0.44) and 0.59 (95% CI: 0.36-0.91), respectively. CONCLUSION: This study gave the first estimates of HSV-2 per-sex-act FtoMTPs in Africa. It demonstrated a synergy between HIV and HSV-2 infections and a protective effect of male circumcision on HSV-2 acquisition by males.

Mots clés: HSV-2; HIV; male circumcision; mathematical modeling; heterosexual transmission

Domaines: Santé publique et épidémiologie

Séverin-Guy Mahiane, Camille Legeai, Dirk Taljaard, Aurélien Latouche, Adrian Puren, et al.. Transmission probabilities of HIV and herpes simplex virus type 2, effect of male circumcision and interaction: a longitudinal study in a township of South Africa.: HSV-2, HIV and male circumcision. AIDS. Official journal of the international AIDS Society, 2009, 23 (3), pp.377-383. ⟨inserm-00371763⟩