Herpes simplex virus and risk of cervical cancer: a longitudinal, nested case-control study in the nordic countries.
Human papillomaviruses (HPVs) play the major role in cervical carcinogenesis. The authors reevaluated the role of herpes simplex virus type 2 (HSV-2) in this multistage process by conducting a longitudinal, nested case-control study using 1974-1993 data and comparing the results with those from a meta-analysis of studies. A Nordic cohort of 550,000 women was followed up for an average of 5 years, after which 178 cervical carcinoma cases and 527 controls were identified. HSV-2; HPV-16, HPV-18, and HPV-33; and Chlamydia trachomatis antibodies were determined at baseline by HSV-2 glycoprotein gG-2 and HPV virus-like-particle enzyme immunoassays and by using the microimmunofluorescence method. The relative risk of cervical carcinoma was calculated by conditional logistic regression. Longitudinal studies on HSV-2 and cervical neoplasia were identified through MEDLINE (National Library of Medicine, Bethesda, Maryland), and weighted mean relative risks were calculated. Smoking (relative risk = 1.6, 95% confidence interval (CI): 1.1, 2.3) and HPV-16/HPV-18/HPV-33 (relative risk = 2.9, 95% CI: 1.9, 4.3) were both associated with cervical carcinoma. The smoking- and HPV-16/HPV-18/HPV-33-adjusted relative risks for HSV-2 were 1.0 (95% CI: 0.6, 1.7) and 0.7 (95% CI: 0.3, 1.6), respectively, for HPV seropositives. In the meta-analysis, the relative risk for HSV-2 was 0.9 (95% CI: 0.6, 1.3). In both sets of data, HSV-2 did not play a role in cervical carcinogenesis.
Lehtinen
Matti
M
School of Public Health, University of Tampere, Finland. llmale@uta.fi
Koskela
Pentti
P
Jellum
Egil
E
Bloigu
Aini
A
Anttila
Tarja
T
Hallmans
Göran
G
Luukkaala
Tiina
T
Thoresen
Steinar
S
Youngman
Linda
L
Dillner
Joakim
J
Hakama
Matti
M
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000453:epidemiology / Q000209:etiology / Q000821:virology*; D016022:Case-Control Studies; D002471:Cell Transformation, Neoplastic; D005260:Female; D005387:Finland / Q000453:epidemiology; D006558:Herpes Genitalis / Q000150:complications*; D018258:Herpesvirus 2, Human / Q000472:pathogenicity*; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D027383:Papillomaviridae / Q000472:pathogenicity; D030361:Papillomavirus Infections / Q000150:complications; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013548:Sweden / Q000453:epidemiology; D014412:Tumor Virus Infections / Q000150:complications; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000821:virology*