Genital tract shedding of herpes simplex virus type 2 in women:: Effects of hormonal contraception, bacterial vaginosis, and vaginal group B Streptococcus colonization
Genital tract shedding of herpes simplex virus type 2 in women:: Effects of hormonal contraception, bacterial vaginosis, and vaginal group B Streptococcus colonization
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DOI：
10.1086/429622
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发表时间：
2005-05-15
影响因子：
11.8
通讯作者：
Hillier, SL
中科院分区：
文献类型：
--
作者：
Cherpes, TL;Melan, MA;Hillier, SL
背景2型单纯疱疹病毒（HSV-2）引起的生殖器感染的特点是病毒频繁复活和脱落，并伴随着传染给性伴侣的风险。我们调查了阴道合并感染和使用激素避孕药对女性生殖道HSV-2脱落的影响。共330名HSV-2血清阳性妇女每4个月随访一年。每次访视时，采集一份阴道拭子标本，通过聚合酶链反应检测HSV-2，采集第二份阴道拭子标本，通过培养检测B族链球菌（GBS）微生物和酵母菌，采集阴道涂片，通过革兰氏染色诊断细菌性阴道病。在956份阴道拭子标本中，88份（9%）检出HSV-2 DNA。生殖道排出HSV-2的独立预测因子是前4个月内HSV-2血清转换（校正比值比[aOR]，3.0; 95%置信区间[CI]，1.3-6.8），细菌性阴道病（aOR，2.3; 95% CI，1.3-4.0）、高密度阴道GBS定植（aOR，2.2; 95% CI，1.3-3.8）和使用激素避孕药（aOR，1.8; 95% CI，1.1-2.8）。本研究确定激素避孕药的使用，细菌性阴道病，高密度的阴道GBS定植的危险因素生殖道脱落的HSV-2的妇女。由于全世界数百万妇女使用激素避孕药，并且由于细菌性阴道病和阴道GBS定植是常见的阴道状况，因此即使与HSV-2脱落的适度关联也会导致病毒传播的重大可归因风险。
Background. Genital infections due to herpes simplex virus type 2 (HSV-2) are characterized by frequent reactivation and shedding of the virus and by the attendant risk of transmission to sexual partners. We investigated the effects of vaginal coinfections and hormonal contraceptive use on genital tract shedding of HSV-2 in women.Methods. A total of 330 HSV-2-seropositive women were followed every 4 months for a year. At each visit, one vaginal swab specimen was obtained for detection of HSV-2 by polymerase chain reaction, a second vaginal swab specimen was obtained for detection of group B Streptococcus (GBS) organisms and yeast by culture, and a vaginal smear was obtained for the diagnosis of bacterial vaginosis by Gram staining.Results. HSV-2 DNA was detected in 88 (9%) of 956 vaginal swab specimens. Independent predictors of genital tract shedding of HSV-2 were HSV-2 seroconversion during the previous 4 months (adjusted odds ratio [aOR], 3.0; 95% confidence interval [CI], 1.3-6.8), bacterial vaginosis (aOR, 2.3; 95% CI, 1.3-4.0), high-density vaginal GBS colonization (aOR, 2.2; 95% CI, 1.3-3.8), and use of hormonal contraceptives (aOR, 1.8; 95% CI, 1.1-2.8).Conclusions. The present study identifies hormonal contraceptive use, bacterial vaginosis, and high-density vaginal GBS colonization as risk factors for genital tract shedding of HSV-2 in women. Because hormonal contraceptives are used by millions of women worldwide and because bacterial vaginosis and vaginal GBS colonization are common vaginal conditions, even modest associations with HSV-2 shedding would result in substantial attributable risks for transmission of the virus.