1568. Herpes Simplex Virus Seroprevalence and Seroconversion Among Active Duty United States Air Force Members with HIV Infection
Session: Poster Abstract Session: Clinical Infectious Diseases: Sexually Transmitted Infections
Saturday, October 10, 2015
Room: Poster Hall
Posters
  • HSV_17JulyFINAL.pdf (191.3 kB)
  • Background:

    Herpes Simplex Virus (HSV) infection is associated with increased risk of HIV transmission and acquisition.  We evaluated longitudinal HSV serology and sexually transmitted infections (STIs) as markers for ongoing high-risk sexual behavior among active duty United States Air Force (USAF) members with HIV infection.   

    Methods:

    All USAF members diagnosed with HIV between 1996-2012 were included and divided into 2 groups (1996-2004 and 2005-2012).  HSV-1/2 serology was evaluated at HIV diagnosis.  Longitudinal HSV-1/2 serology and ICD-9 codes for HSV and non-HSV STIs were also examined for those with ³1 year of follow-up.

    Results:

    HSV-1/2 Serology at HIV Diagnosis*

    Characteristic

    All (n=397)

    1996-2004 (n=131)

    2005-2012 (n=266)

    HSV-2 positive only

    74 (18.6%)

    35 (26.7%)

    39 (14.7%)

    HSV-1/2 positive

    70 (17.6%)

    29 (22.1%)

    41 (15.4%)

    HSV-1 positive only

    156 (39.3%)

    44 (33.6%)

    112 (42.1%)

    HSV-1/2 negative

    97 (24.4%)

    23 (17.6%)

    74 (27.8%)

    *P<0.01 for HIV diagnosis between 1996-2004 vs. 2005-2012

    Baseline characteristics did not differ between groups.  Patients were predominantly male (98.2%) with African Americans (43.4%), Caucasians (44.2%), and Hispanics (8.0%) most common.  Median age, CD4 count and viral load at HIV diagnosis were 28 years, 521 cells/uL and 4.37 log10 copies/mL, respectively.  HSV-2 seroprevalence at HIV diagnosis decreased from the period of 1996-2004 to 2005-2012 (Table; P<0.01).  HSV-2 seropositivity was significantly greater for non-Caucasians (OR 2.19, 95% CI 1.33-3.60) and for HIV diagnosis between 1996-2004 (OR 2.08, 95% CI 1.30-3.33), with a trend observed for those >30 years of age at HIV diagnosis (1.73, 95% CI 0.94-3.18).  During a median follow-up of 4.6 years after HIV diagnosis, 130 (32.7%) patients developed non-HSV STIs and 24 (6.1%) patients had new genital herpes diagnoses by ICD-9 codes.  HSV-2 seroconversion occurred in 33 of 253 (13.0%) patients after a median of 2.6 years.

    Conclusion:

    Although HSV-2 seroprevalence at HIV diagnosis decreased over time in USAF members, high-risk sexual behaviors were ongoing as evidenced by the high proportion of new STI diagnoses and HSV-2 seroconversions.  This study highlights the importance of continued education to reduce high-risk sexual behaviors among HIV-infected patients.

    Jared Cohen, MD1, Amanda Sellers, MS2, T.S. Sunil, PhD, MPH2, Peter Matthews, MD3 and Jason Okulicz, MD4, (1)San Antonio Military Medical Center, Department of Internal Medicine, JBSA Fort Sam Houston, TX, (2)Institute for Health Disparities Research, University of Texas at San Antonio, San Antonio, TX, (3)Mike O'Callaghan Federal Medical Center, Infectious Disease Service, Las Vegas, NV, (4)San Antonio Military Medical Center, Infectious Disease Service, JBSA Fort Sam Houston, TX

    Disclosures:

    J. Cohen, None

    A. Sellers, None

    T. S. Sunil, None

    P. Matthews, None

    J. Okulicz, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.