HSV-2 Prevalence and HIV Diversity among Co-Infected Fishermen along Lake Victoria in Kisumu County

Abstract

Herpes simplex virus type 2 (HSV-2) infections have been associated with a three- fold risk of Human Immunodeficiency Virus-1 (HIV-1) acquisition. The prevalence of HIV-1 and HSV-2 in the fishing communities along the shores of Lake Victoria in Kisumu has been reported to be high. This may contribute to the growing HIV epidemic in Kenya including the spread of transmitted drug resistance (TDR). This study aimed at finding the prevalence of HSV-2, HIV and HSV-2/HIV co-infection, circulating HIV subtypes and the factors associated with these infections. A cross sectional study was conducted where blood samples were obtained from 249 consenting fishermen from four beaches; Nyamware, Kichinjio, Dunga, and Kobudho of Lake Victoria. A questionnaire was administered to collect sociodemographic and related data. Blood samples were analyzed for HIV-1/HSV2 co-infection. The HSV-2 serology was performed using Kalon HSV type 2 enzyme- linked immunosorbent assay (ELISA). The HIV-1 serology was carried out according to local standards of practice in Kenya, using two parallel rapid assays (Alere Determine™ HIV-1/2 and Trinity Biotech Uni-Gold™), with a third ELISA - Vironostika HIV Uni-Form II Ag/Ab for resolving discrepancies. All HIV positive samples were tested for Drug resistance using an in-house HIV-1 pol-RT genotyping protocol. Of the 249 recruited fishermen (mean age 35.1 years), 104 (41.8%) were HIV/HSV-2 negative, 86 (34.5%) were HSV-2 mono-positive, 11 (4.4%) were HIV- 1 mono positive while 48 (19.3%) were HIV/HSV-2 co-infected. HIV-1 subtype A was most common 28/59 (47.5%). Subtypes D, C B, G accounted for 16/59 (27.1%), 3/59 (5.1%), 3/59 (5.1%) and 2/59 (3.4%), respectively. The CRF01_AE recombinant forms were also identified in 7/59 (11.9 %) participants. Low condom use, multiple partners, owning fishing net and being a fisherman was strongly associated with HIV, HSV-2 and HIV/HSV-2 co-infection. There is need for improved STI services and targeted behavioral interventions among this fishing community.