Frequent Genital HSV-2 Shedding among Women during Labor in Soweto, South Africa

Table 1

Baseline participant characteristics.

Characteristic	HIV-positive; 𝑛=132 (34.1%)	HIV-negative; 𝑛=255 (65.9%)	Total; 𝑛=390
Age, mean (range), yrs	29 (18–40)	26 (18–44)	27 (18–44)
Gravidity, 𝑛 (%)
Primigravid	23 (17.6)	112 (44.8)	135 (35.4)
Multigravid	108 (82.4)	138 (55.2)	246 (64.6)
EGA at enrollment, mean (range), weeks	39 (32–44)	39 (30–42)	39 (30–44)
HSV serostatus by Western blot, 𝑛 (%)
HSV-1+ only	16 (12.1)	144 (56.5)^a	161 (41.3)
HSV-2+ only	5 (3.8)	2 (0.8)	7 (1.8)
Both HSV-1+ and HSV-2+	111 (84.1)	109 (42.8)	222 (56.9)
History of genital ulcers among HSV-2 seropositive, 𝑛 (%)	16 (14.2)	6 (5.5)	22 (9.9)
Genital lesions present among HSV-2 seropositive, 𝑛 (%)	3 (2.6)	4 (3.6)	7 (3.1)
CD4 count, median (range), and cells/μL^b	321 (18–1237)
Antiretroviral therapy
HAART^c,d
Any CD4 count	52/132 (39.4)
CD4 ≤ 350 cells/μL	46/70 (65.7)
CD4 ≤ 200 cells/μL	21/26 (80.8)
Prophylaxis to prevent mother-to-child transmission	78 (59.1)
Total receiving antiretroviral drugs^e	131 (99.2)

Abbreviations: EGA: estimated gestational age; HAART: highly active antiretroviral therapy (≥ three antiretroviral drugs). Missing data: HIV-status (𝑛=3), gravidity (𝑛=9), EGA (𝑛=4), history of genital ulcers among HSV-2 seropositive (𝑛=7), and CD4 count (𝑛=6). Percentages determined by excluding those with missing data from the denominator. ^aIncludes one participant with HSV-1 and atypical HSV-2 bands on Western blot at baseline for whom we did not obtain a postpartum Western blot. ^bCD4 count obtained a median of 99 days prior to enrollment (IQR, 57–129 days). ^cDenominator is the number of participants with CD4 count within range specified. ^dIn April 2010, one month prior to initiation of this study, South African National Department of Health guidelines were revised to recommend HAART initiation for all pregnant women with a CD4 count ≤350 cells/μL [27]; previous guidelines recommended HAART initiation for a CD4 count ≤200 cells/μL or WHO stage IV disease. ^eTotal receiving antiretroviral drugs does not equal those receiving HAART+ those receiving prophylaxis to prevent mother-to-child transmission as the only antiretrovirals recorded for one participant were zidovudine and lamivudine.