Co-Infection Prevalence of Herpes Simplex Virus Types 1 and 2 with Human Papillomavirus and Associated Risk Factors among Asymptomatic Women in Ghana

Abstract

Herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) are among the most common human viral infections worldwide and associated with increased risk for other sexually transmitted infections, such as HPV. Unfortunately, there is a dearth of population data on the joint epidemiology of HPV-HSV infections in Ghana. In order to determine the prevalence of HSV-1 and HSV-2 co-infection with HPV and associated risk factors, 317 asymptomatic women attending the Cervicare Centers in Ghana were invited to participate in cross-sectional study. Serum HSV-1 and HSV-2 IgG were determined by ELISA method. Genomic DNA from cervical swabs was extracted using QIAamp Mini kit. HPV-DNA detection was carried out by nested multiplex PCR as was described by Sotlar et al., (2004). The mean age of study participants was 40.7 years (SD ± 11.2). Our result showed the prevalence of HSV-1 and HSV-2 infection among HPV positive women as 98.6% and 80.4% respectively. Among unscreened women participating in the study the co-infection of HSV-1/HPV and HSV-2/HPV was 42.9% and 35.0%, respectively. Age of coitache was associated with sero-prevalence of HSV-1 (p=0.010), HPV infection (p=0.016), and with co-infection HPV and HSV-1 (p=0.025), HPV and HSV-2 (p=0.011) and weakly with single HSV-2 infection (p=0.054). In conclusion, the high prevalence of co-infection was due to the endemicity and inadequate intervention in the study population. A woman’s age of sexual debut was a strong risk factor for co-infection of HPV and HSV-1 or HSV-2. The outcome of this novel observation stresses the urgent need to develop appropriate interventional strategies to manage and cancel patients presenting with asymptomatic genital herpes.