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24 July 2003
Gynecological Complaint Linked To Herpes Risk

A recent investigation from the Magee-Womens Research Institute has found an apparent link between a common gynecological disorder called bacterial vaginosis (BV) and an increased risk for the acquisition of herpes. The researchers, who are affiliated with the University of Pittsburgh, report their findings in the journal Clinical Infectious Diseases.

"We found that women with BV were nearly twice as likely to get herpes as women who did not have BV," said Thomas L. Cherpes, a University of Pittsburgh infectious disease fellow and the study's lead author. "The presence of BV seems to increase susceptibility to herpes infection in women."

Worldwide, herpes simplex virus type 2 (HSV-2) is one of the most prevalent sexually transmitted diseases. At least 45 million people are estimated to have genital herpes in the United States alone, according to Sharon Hillier, of the University of Pittsburgh School of Medicine and senior author of the study.

"Symptoms of discharge are one of the most common reasons women visit a gynecologist," said Dr. Hillier, adding that BV rates in some populations are estimated as high as 50 percent. "Other studies, too, have shown that women who have BV are more likely to get other sexually transmitted diseases such as gonorrhea and HIV." The Pittsburgh study also noted that risk appeared to be higher among African-American women.

BV is characterized by an increase in vaginal alkalinity and substitution of certain beneficial bacteria, particularly those that produce hydrogen peroxide, with more toxic bacteria. This depletion of hydrogen peroxide-producing bacteria is believed to result in diminished defense against sexually transmitted diseases.

The University of Pittsburgh study involved 1,248 sexually active women 18 to 30 years of age. After initial screening for BV and HSV-2 status, the women were asked to return three more times at four-month intervals for follow-up testing. At each visit, vaginal swabs and blood samples were collected for subsequent evaluation.

Out of the 670 women who were negative for HSV-2 at enrollment, 32 acquired antibodies to HSV-2 during the study period. When adjusted for other variables, it became clear that the presence of BV was a significant indicator of risk for subsequent HSV-2 infection when compared with women who had normal vaginal flora.

"It seems likely that more comprehensive screening and appropriate treatment could reduce susceptibility to HSV-2," said Dr. Hillier.

Unlike HSV-2, which typically has a life-long duration of infection, BV can often be effectively treated with a short course of antibiotics.


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