Viral infections and lower urinary tract symptoms in the third national health and nutrition examination survey.
OBJECTIVE
Previous epidemiological studies described suggestive positive associations between sexually transmitted infections, particularly gonorrhea and human immunodeficiency virus infection, and lower urinary tract symptoms. To our knowledge no groups have investigated other infections, such as human papillomavirus type 16, herpes simplex virus type 2, cytomegalovirus, human herpesvirus type 8, herpes simplex type 1, and hepatitis B and C virus infection, in relation to lower urinary tract symptoms. Therefore, we examined each of these associations in the Third National Health and Nutrition Examination Survey.


METHODS
The Third National Health and Nutrition Examination Survey is a representative, cross-sectional survey of the population in the United States that was done between 1988 and 1994. Each participant provided a blood sample and completed a computer assisted interview including questions on lower urinary tract symptoms (nocturia, incomplete emptying, hesitancy and weak stream). Blood samples were tested for IgG antibodies against each virus.


RESULTS
In younger men (ages 30 to 49 years) positive associations were observed between cytomegalovirus, human herpesvirus type 8, herpes simplex virus type 1, and hepatitis B and C virus antibody seropositivity, and lower urinary tract symptoms. In 50 to 59-year-old men positive associations were observed between human papillomavirus type 16, herpes simplex virus type 2, cytomegalovirus, human herpesvirus type 8 and hepatitis C virus antibody seropositivity and lower urinary tract symptoms. In men 60 years or older only a slight, nonsignificant positive association was observed between cytomegalovirus antibody seropositivity and lower urinary tract symptoms.


CONCLUSIONS
In this cross-sectional survey of American men suggestive positive associations were observed between several viral infections and lower urinary tract symptoms, primarily in 30 to 59-year-old men. These findings provide interesting hypotheses and preliminary evidence for future etiological studies of infections and lower urinary tract symptoms.
Sutcliffe
Siobhan
S
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Rohrmann
Sabine
S
Giovannucci
Edward
E
Nelson
Kenrad E
KE
De Marzo
Angelo M
AM
Isaacs
William B
WB
Nelson
William G
WG
Platz
Elizabeth A
EA
D000328:Adult; D000888:Antibodies, Anti-Idiotypic / Q000032:analysis; D000914:Antibodies, Viral / Q000032:analysis; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D011379:Prognosis; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D014555:Urination Disorders / Q000453:epidemiology* / Q000209:etiology; D014777:Virus Diseases / Q000150:complications / Q000453:epidemiology*; D014780:Viruses / Q000276:immunology
D000888:Antibodies, Anti-Idiotypic; D000914:Antibodies, Viral; D007074:Immunoglobulin G