Association between Acquisition of Herpes Simplex Virus Type 2 in Women and Bacterial Vaginosis

TLDR

The study aimed to identify factors linked to HSV‑2 acquisition among sexually active women and to evaluate whether screening and treating bacterial vaginosis could lower HSV‑2 susceptibility. A longitudinal cohort of 670 HSV‑2 seronegative, sexually active women aged 18–30 was followed every four months for one year to monitor HSV‑2 seroconversion. During the year, 32 of 670 women seroconverted, with black race, low education, new partners, and bacterial vaginosis emerging as significant risk factors, and BV remained independently associated with HSV‑2 acquisition (HR 2.1, 95 % CI 1.0–4.5, P = 0.05) accounting for 21 % of seroconversions, while prior HSV‑1 infection offered no protection.

Abstract

A longitudinal cohort study of sexually active women 18–30 years of age was conducted to identify variables associated with the acquisition of herpes simplex virus type 2 (HSV-2) infections. Six hundred seventy HSV-2–seronegative women were followed up at 4-month intervals for 1 year; acquisition of HSV-2 antibodies was detected in 32 of these women. Black race, ⩽12 years of education, having a new sex partner, and bacterial vaginosis (BV) were associated with HSV-2 seroconversion on univariate analysis. Antecedent HSV-1 infection was not protective against HSV-2 acquisition. After controlling for other identified risk factors in multivariable models, the diagnosis of BV remained associated with an increased risk of acquiring HSV-2 infection (hazard ratio, 2.1; 95% confidence interval, 1.0–4.5; P = .05). In this study, the population attributable risk of BV for HSV-2 seroconversion was 21%. Additional studies are needed to determine whether screening and treatment of BV could reduce susceptibility to the acquisition of HSV-2 in women.