Browsing by Author "Meehan, Mary P."

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    Determinants of HIV-1 Load in Subjects with Early and Later HIV Infections, in a General-Population Cohort of Rakai, Uganda
    (Journal of Infectious Diseases, 2004) Gray, Ronald H.; Li, X.; Wawer, Maria J.; Serwadda, David; Sewankambo, Nelson K.; Wabwire-Mangen, Fred; Lutalo, Tom; Kiwanuka, Noah; Kigozi, Godfrey; Nalugoda, Fred; Meehan, Mary P.; Quinn, Thomas C.
    Human immunodeficiency virus (HIV) type 1 RNA loads were determined for 256 subjects with early (incident) HIV infection and for 1293 subjects with later (prevalent) HIV infection, in a Ugandan cohort. Prevalent infections were classified as latent (0–1 symptoms) and midstage disease ( 2 symptoms), and deaths were ascribed to acquired immunodeficiency syndrome. Among subjects with incident HIV infection, HIV load did not differ by sex, but, among subjects with prevalent HIV infection, it was higher in males than in females. HIV load was highest in subjects (25–29 years old) with incident HIV infection but increased with age in subjects with prevalent HIV infection. Viremia was higher after serconversion than in latency and increased with more advanced disease. Viremia was increased with genital ulcer disease (GUD) in both subjects with incident infection and in those with prevalent infection, and with herpes simplex virus type 2 seropositivity in subjects with incident HIV infection. GUD was consistently associated with higher HIV loads in subjects with incident and those with prevalent HIV infection, suggesting that treatment of GUD might reduce HIV viremia.
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    Human Immunodeficiency Virus Acquisition Associated with Genital Ulcer Disease and Herpes Simplex Virus Type 2 Infection: A Nested Case-Control Study in Rakai, Uganda
    (The Journal of infectious diseases, 2003) Serwadda, David; Gray, Ronald H.; Sewankambo, Nelson K.; Wabwire-Mangen, Fred; Cheng, Michael Z.; Quinn, Thomas C.; Lutalo, Tom; Kiwanuka, Noah; Kigozi, Godfrey; Nalugoda, Fred; Meehan, Mary P.; Morrow, Rhoda A.; Wawer, Maria J.
    To assess the timing of symptomatic genital ulcer disease (GUD) relative to human immunodeficiency virus (HIV) seroconversion, we studied 248 case subjects who underwent HIV seroconversion and 496 HIV-negative control subjects, at 3 interview visits conducted at 10-month intervals: visit 1, before HIV acquisition; visit 2, after seroconversion; and visit 3, 10 months after detection of seroconversion. Odds ratios (ORs) and 95% confidence intervals (CIs), for HIV acquisition, were estimated by logistic regression. HIV load was measured by RNA–polymerase chain reaction, and herpes simplex virus type 2 (HSV-2) serologic testing used HerpeSelect EIA with Western blot confirmation. The OR of HSV-2 seropositivity associated with HIV acquisition was 1.7 (95% CI, 1.2–2.4). Prevalence of GUD was increased among case subjects, at visits 2 (OR, 3.2; 95% CI, 1.9– 5.3) and 3 (OR, 2.1; 95% CI, 1.1–3.9). HIV load was increased in HSV-2–seropositive case subjects, compared with that in HSV-2–seronegative subjects, at 5 (Pp.04) and 15 (Pp.02) months after seroconversion. HIV acquisition is associated with HSV-2 seropositivity, and GUD is increased after seroconversion. HIV load is increased in HSV-2–positive subjects who seroconverted, suggesting a role for treatment of HSV-2 infection in HSV-2–seropositive, dually infected individuals.