Recalcitrance of bacterial vaginosis among herpes-simplex-virus-type-2-seropositive women.
Recalcitrance of bacterial vaginosis among herpes-simplex-virus-type-2-seropositive women.
复制标题
单纯疱疹病毒 2 型血清阳性女性中细菌性阴道病的顽固性。
DOI：
10.1111/j.1447-0756.2011.01697.x
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发表时间：
2012
期刊：
影响因子：
--
通讯作者：
Cherpes,ThomasL
中科院分区：
文献类型：
--
作者：
Stoner,KevinA;Reighard,SethD;VicettiMiguel,RodolfoD;Landsittel,Douglas;Cosentino,LisaA;Kant,JeffreyA;Cherpes,ThomasL
Aim:The multifactorial etiology of bacterial vaginosis (BV) impedes development of effective treatment and prevention strategies. Herein, we evaluated the effects of herpes simplex virus type 2 (HSV‐2), a suspected BV risk factor, on vaginal flora composition.Materials and Methods:Correlations between HSV‐2 infection and BV were prospectively explored among 12 HSV‐2‐seropositive women with asymptomatic BV who were asked to collect daily vaginal swab specimens for Gram stain analysis of vaginal flora and determination of HSV‐2 shedding frequencies during the 1 month before and after metronidazole therapy.Results:Unlike prior longitudinal studies that reported rapid fluctuations in vaginal flora composition and frequent episodes of spontaneously resolving BV, we found that 99.4% (310/312) of vaginal smears collected before initiation of metronidazole were consistent with a diagnosis of BV. Effectiveness of metronidazole therapy was also much lower than previously reported in studies not restricting enrollment to HSV‐2‐seropositive women; we observed a BV recurrence rate of 89% in the first month after completion of therapy while the median time to this recurrence occurred only 14 days after treatment.Conclusions:Our study demonstrates BV recalcitrance among HSV‐2‐infected women and provides additional evidence for a linkage between this chronic viral infection and abnormal vaginal flora. Additional work will be needed to define mechanisms responsible for this correlation and to determine if vaginal flora health of HSV‐2‐infected women is improved by medications that suppress HSV‐2 shedding.
