Cervical shedding of herpes simplex virus in human immunodeficiency virus-infected women: effects of hormonal contraception, pregnancy, and vitamin A deficiency.
Genital shedding of herpes simplex virus (HSV) results in frequent transmission of infection to sexual partners and neonates. In a cross-sectional study, cervical shedding of HSV DNA was detected in 43 (17%) cervical swab samples from 273 women seropositive for HSV-1, HSV-2, and human immunodeficiency virus type 1 (HIV-1). Cervical shedding of HSV was significantly associated with oral contraception (adjusted odds ratio [aOR], 4.5; 95% confidence interval [CI], 1.7-12.2), use of depo-medroxyprogesterone acetate (aOR, 3.2; 95% CI, 1.3-7.7), and pregnancy (aOR, 7.9; 95% CI, 2.0-31.7). In the subgroup of women who were not pregnant and not using hormonal contraception (n=178), serum vitamin A was highly predictive of cervical HSV shedding: concentrations indicating severe deficiency, moderate deficiency, low-normal, and high-normal status were associated with 29%, 18%, 8%, and 2% prevalences of cervical HSV shedding, respectively (linear trend, P=.0002). Several factors appear to influence HSV reactivation in HIV-1 seropositive women.
Mostad
S B
SB
International AIDS Research and Training Program, Department of Epidemiology, University of Washington, Seattle, Washington 98195, USA.
Kreiss
J K
JK
Ryncarz
A J
AJ
Mandaliya
K
K
Chohan
B
B
Ndinya-Achola
J
J
Bwayo
J J
JJ
Corey
L
L
D002584:Cervix Uteri / Q000821:virology*; D003267:Contraception; D003278:Contraceptives, Oral, Hormonal; D003430:Cross-Sectional Studies; D005260:Female; D006679:HIV Seropositivity / Q000821:virology*; D015497:HIV-1; D006561:Herpes Simplex / Q000821:virology*; D006801:Humans; D007630:Kenya; D011247:Pregnancy; D017201:Virus Shedding; D014802:Vitamin A Deficiency
D003278:Contraceptives, Oral, Hormonal