ABSTRACT
Background: Viral infection with Herpes Simplex Virus (HSV) is one of the commonest opportunistic infection in HIV seropositive patients. Studies have confirmed that genital herpes caused by HSV-2 has been associated with twofold to threefold increased risk of HIV acquisition. This study was designed to determine the seroprevalence of HSV-2 in HIV positive patients. Methods: This was a prospective, cross sectional study conducted from July 2012 to January 2013. After obtaining written informed consent, HIV positive patients were enrolled into the study. Demographic characteristics were recorded. Serology test was performed using HSV-2 IgG ELISA test kit from Calbiotech, USA. Results were analyzed using Chi-squared test. Results: Out of two hundred and seventy three HIV positive patients enrolled, 67% were males, 33% were females and one transgender. Average age was 38.8 years. Overall 50% of HIV positive patients had HSV-2 IgG antibodies. Seroprevalence of HSV-2 among HIV positive men and women were 47% and 57% respectively. The highest HSV-2 seropositivity was detected in the age group of 36 to 45 years. Chi-squared analysis showed a statistically significant association between HSV-2 and HIV infection (X2 = 55.900, P = 0.0076). The median CD4 counts estimated in 100 patients were 563.50 cells/mm3. There was no significant difference in CD4 counts of those with or without HSV-2. Conclusions: HSV-2 prevalence was higher in HIV positive women than in men. The implementation of continuous interventions for STIs and HIV will bring down the prevalence and spread of both HSV-2 and HIV infection.
ABSTRACT
Background: Single dose of Nevirapine to prevent mother to child transmission of HIV is the commonest preventive regimen in resource-limited countries. Objectives: The objective of this study was to detect drug-resistant virus after single dose of Nevirapine (sdNVP) provided to delivering HIV seropositive (HIV+ve) women and to evaluate the time taken for its decay. Results: Of the 36 consenting HIV+ve pregnant women enrolled into the study, the mean hemoglobin and total lymphocyte counts were 10.8 g/dl and 1843 cells/mm 3 , respectively. Mean CD4 counts in 64% of women was 363 cells/mm 3 and mean viral load for 16/36 women was 28,143 copies/ml of plasma. Nevirapine-resistance mutations were detected in 28% of women at delivery; using OLA (Oligonucleotide Ligation Assay). K103N mutations were seen in 19.4% of women while the Y181C mutation was seen in 5%. Both the mutations were detected in 2.7% of women. Sequential blood samples collected at delivery, 7-10 days, 6 weeks, 4 months, 6 months and one year postpartum showed that 81% of K103N mutations and 66.7% of Y181C mutations were detected at 6 weeks postpartum . Wild-type virus had replaced the mutants by one year postpartum in all women except one. Conclusion : These observations are relevant for future treatment with antiretroviral therapy in these women for their HIV disease.