High Seroprevalence of Human Herpesviruses in HIV-Infected Individuals Attending Primary Healthcare Facilities in Rural South Africa

Seroprevalence data of human herpesviruses (HHVs) are limited for sub-Saharan Africa. These are important to provide an indication of potential burden of HHV-related disease, in particular in human immunodeficiency virus (HIV)-infected individuals who are known to be at increased risk of these conditions in the Western world. In this cross-sectional study among 405 HIV-infected and antiretroviral therapy naïve individuals in rural South Africa the seroprevalence of HHVs was: herpes simplex virus type 1 (HSV-1) (98%), herpes simplex virus type 2 (HSV-2) (87%), varicella zoster virus (VZV) (89%), and 100% for both Epstein-Barr virus (EBV) and cytomegalovirus (CMV). Independent factors associated with VZV seropositivity were low educational status and having children. Lack of in-house access to drinking water was independently associated with positive HSV-1 serostatus, whereas Shangaan ethnicity was associated with HSV-2 seropositivity. Increasing age was associated with higher IgG titres to both EBV and CMV, whereas CD4 cell count was negatively associated with EBV and CMV IgG titres. Moreover, IgG titres of HSV-1 and 2, VZV and CMV, and CMV and EBV were positively correlated. The high HHV seroprevalence emphasises the importance of awareness of these viral infections in HIV-infected individuals in South Africa.

撒哈拉以南非洲地区的人类疱疹病毒（human herpesviruses, HHVs）血清流行率（seroprevalence）数据较为匮乏。此类数据对于评估HHVs相关疾病的潜在疾病负担具有重要意义，尤其针对西方世界中已知罹患此类疾病风险升高的人类免疫缺陷病毒（human immunodeficiency virus, HIV）感染者群体。本研究针对南非农村地区的405名HIV感染者及未经抗反转录病毒治疗（antiretroviral therapy, ART）的个体开展横断面研究（cross-sectional study），结果显示各类HHVs的血清流行率分别为：1型单纯疱疹病毒（herpes simplex virus type 1, HSV-1）98%、2型单纯疱疹病毒（herpes simplex virus type 2, HSV-2）87%、水痘带状疱疹病毒（varicella zoster virus, VZV）89%，而EB病毒（Epstein-Barr virus, EBV）与巨细胞病毒（cytomegalovirus, CMV）的血清流行率均为100%。与VZV血清阳性独立相关的因素为低学历状态及育有子女。缺乏户内饮用水获取途径与HSV-1血清阳性状态呈独立相关性，而尚加纳族（Shangaan ethnicity）则与HSV-2血清阳性存在关联。年龄增长与EBV及CMV的IgG抗体滴度（IgG titres）升高呈正相关，而CD4细胞计数（CD4 cell count）则与EBV、CMV的IgG抗体滴度呈负相关。此外，HSV-1与HSV-2、VZV与CMV，以及CMV与EBV的IgG抗体滴度均呈正相关。如此高的HHVs血清流行率凸显了南非HIV感染者群体中此类病毒感染认知的重要性。