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Ivanina A, Leneva I, Falynskova I, Glubokova E, Kartashova N, Pankova N, Korovkin S, Svitich O. The Topical Novel Formulations of Interferon α-2в Effectively Inhibit HSV-1 Keratitis in the Rabbit Eye Model and HSV-2 Genital Herpes in Mice. Viruses 2024; 16:989. [PMID: 38932280 PMCID: PMC11209562 DOI: 10.3390/v16060989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 05/28/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024] Open
Abstract
Herpes simplex viruses type 1 (HSV-1) and type 2 (HSV-2) are widespread human pathogens that establish chronic latent infections leading to recurrent episodes. Current treatments are limited, necessitating the development of novel antiviral strategies. This study aimed to assess the antiviral efficacy of novel topical formulations containing interferon alpha-2b (IFN α-2b) against HSV-1 and HSV-2. The formulations, Oftalmoferon® forte (eye drops) and Interferon Vaginal Tablets, demonstrated potent antiviral effects against HSV-1 and HSV-2 in Vero cells, respectively, with concentration-dependent inhibition of viral replication. Subsequently, their efficacy was tested in animal models: HSV-1 keratitis in the rabbit eye model and HSV-2 genital herpes in mice. Oftalmoferon® forte effectively treated HSV-1 keratitis, reducing clinical symptoms and ulcerations compared to virus control. Interferon Vaginal Tablets showed promising results in controlling HSV-2 genital herpes in mice, improving survival rates, reducing clinical signs, weight loss and viral replication. The novel IFN α-2b formulations exhibited significant antiviral activity against HSV infections in cell culture and animal models. These findings suggest the potential of these formulations as alternative treatments for HSV infections, particularly in cases resistant to current therapies. Further studies are warranted to optimize treatment regimens and assess clinical efficacy in humans.
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Affiliation(s)
- Anna Ivanina
- Mechnikov Research Institute of Vaccines and Sera, Department of Virology, 105064 Moscow, Russia; (I.L.); (I.F.); (E.G.); (N.K.); (O.S.)
| | - Irina Leneva
- Mechnikov Research Institute of Vaccines and Sera, Department of Virology, 105064 Moscow, Russia; (I.L.); (I.F.); (E.G.); (N.K.); (O.S.)
| | - Irina Falynskova
- Mechnikov Research Institute of Vaccines and Sera, Department of Virology, 105064 Moscow, Russia; (I.L.); (I.F.); (E.G.); (N.K.); (O.S.)
| | - Ekaterina Glubokova
- Mechnikov Research Institute of Vaccines and Sera, Department of Virology, 105064 Moscow, Russia; (I.L.); (I.F.); (E.G.); (N.K.); (O.S.)
| | - Nadezhda Kartashova
- Mechnikov Research Institute of Vaccines and Sera, Department of Virology, 105064 Moscow, Russia; (I.L.); (I.F.); (E.G.); (N.K.); (O.S.)
| | - Nadezda Pankova
- OOO Firn M, Biotech Company, 108804 Moscow, Russia; (N.P.); (S.K.)
| | - Sergei Korovkin
- OOO Firn M, Biotech Company, 108804 Moscow, Russia; (N.P.); (S.K.)
| | - Oxana Svitich
- Mechnikov Research Institute of Vaccines and Sera, Department of Virology, 105064 Moscow, Russia; (I.L.); (I.F.); (E.G.); (N.K.); (O.S.)
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Roa CL, Cipolla-Neto J, Reiter RJ, Linhares IM, Lepique AP, de Aguiar LM, Seganfredo IB, Ferreira-Filho ES, de Medeiros SF, Baracat EC, Soares-Júnior JM. Effects of Melatonin Alone or Associated with Acyclovir on the Suppressive Treatment of Recurrent Genital Herpes: A Prospective, Randomized, and Double-Blind Study. Biomedicines 2023; 11:biomedicines11041088. [PMID: 37189706 DOI: 10.3390/biomedicines11041088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/20/2023] [Accepted: 03/28/2023] [Indexed: 04/07/2023] Open
Abstract
Suppressive therapy of recurrent genital herpes is a challenge, and melatonin may be an alternative. Objective: To evaluate the action of melatonin, acyclovir, or the association of melatonin with acyclovir as a suppressive treatment in women with recurrent genital herpes. Design: The study was prospective, double-blind, and randomized, including 56 patients as follows: (a) The melatonin group received 180 placebo capsules in the ‘day’ container and 180 melatonin 3 mg capsules in the ‘night’ container (n = 19); (b) The acyclovir group received 360 capsules of 400 mg acyclovir twice a day (one capsule during the day and another during the night) (n = 15); (c) the melatonin group received 180 placebo capsules in the ‘day’ container and 180 melatonin 3 mg capsules in the ‘night’ container (n = 22). The length of treatment was six months. The follow-up after treatment was six months. Patients were evaluated before, during, and after treatment through clinical visits, laboratory tests, and the application of four questionnaires (QSF-36, Beck, Epworth, VAS, and LANNS). Results: No statistically significant difference was observed for the depression and sleepiness questionnaires. However, in the Lanns scale for pain, all groups decreased the mean and median values in time (p = 0.001), without differentiation among the groups (p = 0.188). The recurrence rates of genital herpes within 60 days after treatment were 15.8%, 33.3%, and 36.4% in the melatonin, acyclovir, and association of melatonin with acyclovir groups, respectively. Conclusion: Our data suggest that melatonin may be an option for the suppressive treatment of recurrent genital herpes.
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Affiliation(s)
- Cristiane Lima Roa
- Discipline of Gynecology, Obstetrics and Gynecology Department, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, SP, Brazil
| | - José Cipolla-Neto
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo (USP), São Paulo 05508-000, SP, Brazil
| | - Russel J. Reiter
- Department of Cellular and Structural Biology, UT Health Science Center, San Antonio, TX 78229, USA
| | - Iara Moreno Linhares
- Discipline of Gynecology, Obstetrics and Gynecology Department, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, SP, Brazil
| | - Ana Paula Lepique
- Biomedical Building IV—Department of Immunology, Instituto de Ciências Biomédicas—USP, Universidade de São Paulo, São Paulo 05508-000, SP, Brazil
| | - Lana Maria de Aguiar
- Discipline of Gynecology, Obstetrics and Gynecology Department, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, SP, Brazil
| | - Isadora Braga Seganfredo
- Discipline of Gynecology, Obstetrics and Gynecology Department, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, SP, Brazil
| | - Edson Santos Ferreira-Filho
- Discipline of Gynecology, Obstetrics and Gynecology Department, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, SP, Brazil
| | | | - Edmund Chada Baracat
- Discipline of Gynecology, Obstetrics and Gynecology Department, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, SP, Brazil
| | - José Maria Soares-Júnior
- Discipline of Gynecology, Obstetrics and Gynecology Department, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, SP, Brazil
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Warnecke JM, Pollmann M, Borchardt-Lohölter V, Moreira-Soto A, Kaya S, Sener AG, Gómez-Guzmán E, Figueroa-Hernández L, Li W, Li F, Buska K, Zakaszewska K, Ziolkowska K, Janz J, Ott A, Scheper T, Meyer W. Seroprevalences of antibodies against ToRCH infectious pathogens in women of childbearing age residing in Brazil, Mexico, Germany, Poland, Turkey and China. Epidemiol Infect 2020; 148:e271. [PMID: 33124529 PMCID: PMC7689786 DOI: 10.1017/s0950268820002629] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/17/2020] [Accepted: 10/26/2020] [Indexed: 12/12/2022] Open
Abstract
Determination of antibodies against ToRCH antigens at the beginning of pregnancy allows assessment of both the maternal immune status and the risks to an adverse pregnancy outcome. Age-standardised seroprevalences were determined in sera from 1009 women of childbearing age residing in Mexico, Brazil, Germany, Poland, Turkey or China using a multiparametric immunoblot containing antigen substrates for antibodies against Toxoplasma gondii, rubella virus, cytomegalovirus (CMV), herpes simplex viruses (HSV-1, HSV-2), Bordetella pertussis, Chlamydia trachomatis, parvovirus B19, Treponema pallidum and varicella zoster virus (VZV). Seroprevalences for antibodies against HSV-1 were >90% in samples from Brazil and Turkey, whereas the other four countries showed lower mean age-adjusted seroprevalences (range: 62.5-87.9%). Samples from Brazilian women showed elevated seroprevalences of antibodies against HSV-2 (40.1%), C. trachomatis (46.8%) and B. pertussis (56.6%) compared to the other five countries. Seroprevalences of anti-T. gondii antibodies (0.5%) and anti-parvovirus B19 antibodies (7.5%) were low in samples from Chinese women, compared to the other five countries. Samples from German women revealed a low age-standardised seroprevalence of anti-CMV antibodies (28.8%) compared to the other five countries. These global differences in immune status of women in childbearing age advocate country-specific prophylaxis strategies to avoid infection with ToRCH pathogens.
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Affiliation(s)
- J. M. Warnecke
- Institute for Experimental Immunology, EUROIMMUN Medizinische Labordiagnostika AG, Lübeck, Germany
| | - M. Pollmann
- Institute for Experimental Immunology, EUROIMMUN Medizinische Labordiagnostika AG, Lübeck, Germany
| | - V. Borchardt-Lohölter
- Institute for Experimental Immunology, EUROIMMUN Medizinische Labordiagnostika AG, Lübeck, Germany
| | - A. Moreira-Soto
- Institute of Virology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - S. Kaya
- Department of Medical Microbiology, İzmir Katip Çelebi University, Ataturk Training and Research Hospital, İzmir, Turkey
| | - A. G. Sener
- Department of Medical Microbiology, İzmir Katip Çelebi University, Ataturk Training and Research Hospital, İzmir, Turkey
| | - E. Gómez-Guzmán
- Department of Science and Biotechnology, INOCHEM S.A. DE C.V., Col. San Miguel Ajusco, Mexico City, Mexico
| | - L. Figueroa-Hernández
- National Institute of Respiratory Diseases, Immunology and Autoimmunity Laboratory, Mexico City, Mexico
| | - W. Li
- EUROIMMUN Medical Diagnostics China Co., Ltd., Beijing, China
| | - F. Li
- EUROIMMUN Medical Diagnostics China Co., Ltd., Beijing, China
| | - K. Buska
- EUROIMMUN Polska Sp. z.o.o., Wroclaw, Poland
| | | | - K. Ziolkowska
- Department of Laboratory Diagnostics, K. Marcinkowski Poznań University of Medical Sciences, Poznan, Poland
- Central Laboratory, Gynaecology and Obstetrics Clinical Hospital Poznan University of Medical Sciences, Poznan, Poland
| | - J. Janz
- Institute for Experimental Immunology, EUROIMMUN Medizinische Labordiagnostika AG, Lübeck, Germany
| | - A. Ott
- Institute for Experimental Immunology, EUROIMMUN Medizinische Labordiagnostika AG, Lübeck, Germany
| | - T. Scheper
- Institute for Experimental Immunology, EUROIMMUN Medizinische Labordiagnostika AG, Lübeck, Germany
| | - W. Meyer
- Institute for Experimental Immunology, EUROIMMUN Medizinische Labordiagnostika AG, Lübeck, Germany
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In Vitro and In Vivo Activity, Tolerability, and Mechanism of Action of BX795 as an Antiviral against Herpes Simplex Virus 2 Genital Infection. Antimicrob Agents Chemother 2020; 64:AAC.00245-20. [PMID: 32601167 DOI: 10.1128/aac.00245-20] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 06/23/2020] [Indexed: 11/20/2022] Open
Abstract
Herpes simplex virus type 2 (HSV-2) causes recurrent lesions in the anogenital area that may be transmitted through sexual encounters. Nucleoside analogs, such as acyclovir (ACV), are currently prescribed clinically to curb this infection. However, in some cases, reduced efficacy has been observed due to the emergence of resistance against these drugs. In our previous study, we reported the discovery of a novel anti-HSV-1 small molecule, BX795, which was originally used as an inhibitor of TANK-binding kinase 1 (TBK1). In this study, we report the antiviral efficacy of BX795 on HSV-2 infection in vaginal epithelial cells in vitro at 10 μM and in vivo at 50 μM. Additionally, through biochemical assays in vitro and histopathology in vivo, we show the tolerability of BX795 in vaginal epithelial cells at concentrations as high as 80 μM. Our investigations also revealed that the mechanism of action of BX795 antiviral activity stems from the reduction of viral protein translation via inhibition of protein kinase B phosphorylation. Finally, using a murine model of vaginal infection, we show that topical therapy using 50 μM BX795 is well tolerated and efficacious in controlling HSV-2 replication.
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5
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Drisu UI, Oronsaye FE, Adejumo BIG, Uchuno GA, Emmanuel AM, Dimkpa U, Omosor KI, Adebowale MO, Abdulrahman ON, Ukatu EN. Seroprevalence, Type-Specific of Herpes Simplex Virus and Associated Risk Factors among Women of Child Bearing Age in Kogi State, Nigeria. Health (London) 2018. [DOI: 10.4236/health.2018.107075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Vista ES, Weisman MH, Ishimori ML, Chen H, Bourn RL, Bruner BF, Hamijoyo L, Tanangunan RD, Gal NJ, Robertson JM, Harley JB, Guthridge JM, Navarra SV, James JA. Strong viral associations with SLE among Filipinos. Lupus Sci Med 2017; 4:e000214. [PMID: 29214036 PMCID: PMC5704743 DOI: 10.1136/lupus-2017-000214] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 05/25/2017] [Accepted: 05/31/2017] [Indexed: 01/04/2023]
Abstract
Objectives Epstein-Barr virus (EBV) is considered an important environmental factor in SLE aetiology, but the relationship between SLE and EBV in the Filipino population is unknown. We tested associations between SLE, lupus-associated autoantibodies and seropositivity for EBV and other herpes viruses in the Filipino population. Methods Sera from Filipino patients with SLE (n=233), unaffected first-degree relatives (FDRs, n=543) and unrelated controls (n=221) were tested for antibodies against EBV, cytomegalovirus (CMV) and herpes simplex viruses (HSV-1 and HSV-2) by standardised ELISAs. Humoral specificity against EBV nuclear antigen (EBNA)-1 was compared by solid-phase epitope mapping. Autoantibodies were detected by a bead-based multiplex assay. Results were analysed by Fisher's exact test, Student's t-test, χ2 test and one-way analysis of variance, as appropriate for the question. Results Filipino patients with SLE had increased seroprevalence and elevated antibody concentrations against EBV viral capsid antigen (EBV-VCA), CMV, HSV-1 and HSV-2 compared with unrelated controls (p<0.05). Seropositivity for anti-EBV early antigen (EA), a marker of EBV reactivation, was dramatically increased in patients with SLE compared with unrelated controls (92.3% vs 40.4%; OR 17.15(95% CI 10.10, 30.66), p<0.0001) or unaffected FDRs (49.4%; OR 12.04(7.42, 20.74), p<0.0001), despite similar seroprevalence of EBV-VCA in patients and FDRs. In patients with SLE, EBV-EA seropositivity correlated with lupus-associated autoantibodies (p<0.001), most notably with autoantibodies against dsDNA, chromatin, Sm, SmRNP and RNP A (p<0.01). Patient and unrelated control sera reacted to the highly repetitive glycine and alanine domain of EBNA-1. An epitope spanning EBNA-1410-420 was identified in sera of patients with SLE and showed limited binding by FDR and control sera. Conclusions Filipino patients with SLE have elevated prevalence and concentrations of antibodies against EBV, CMV, HSV-1 and HSV-2 antigens, along with altered anti-EBNA-1 specificities. EBV reactivation is more common among Filipino patients with SLE compared with healthy Filipinos and may contribute to SLE pathogenesis in this population.
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Affiliation(s)
- Evan S Vista
- Section of Rheumatology, University of Santo Tomas Hospital, Manila, Philippines.,Arthritis & Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA
| | - Michael H Weisman
- Department of Medicine, Division of Rheumatology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Mariko L Ishimori
- Department of Medicine, Division of Rheumatology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Hua Chen
- Arthritis & Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA
| | - Rebecka L Bourn
- Arthritis & Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA
| | - Ben F Bruner
- Arthritis & Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA.,Department of Biology, Harding University, Searcy, Arkansas, USA
| | - Laniyati Hamijoyo
- Section of Rheumatology, University of Santo Tomas Hospital, Manila, Philippines
| | - Robelle D Tanangunan
- Section of Rheumatology, University of Santo Tomas Hospital, Manila, Philippines
| | - Noga J Gal
- Department of Medicine, Division of Rheumatology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Julie M Robertson
- Arthritis & Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA
| | - John B Harley
- Center for Autoimmune Genomics and Etiology (CAGE), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Department of Veterans Affairs Medical Center, Cincinnati, Ohio, USA
| | - Joel M Guthridge
- Arthritis & Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA
| | - Sandra V Navarra
- Section of Rheumatology, University of Santo Tomas Hospital, Manila, Philippines
| | - Judith A James
- Arthritis & Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA.,Departments of Medicine and Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
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Herpes simplex virus 2 infection: molecular association with HIV and novel microbicides to prevent disease. Med Microbiol Immunol 2014; 204:161-76. [PMID: 25209142 PMCID: PMC7102243 DOI: 10.1007/s00430-014-0358-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Accepted: 09/01/2014] [Indexed: 12/17/2022]
Abstract
Infection with herpes simplex viruses is one of the most ancient diseases described to affect humans. Infection with these viruses produces vexing effects to the host, which frequently recur. Infection with herpes simplex viruses is lifelong, and currently there is no vaccine or drug to prevent or cure infection. Prevalence of herpes simplex virus 2 (HSV-2) infection varies significantly depending on the geographical region and nears 20 % worldwide. Importantly, HSV-2 is the first cause of genital ulcers in the planet. HSV-2 affects approximately 500 million people around the globe and significantly increases the likelihood of acquiring the human immunodeficiency virus (HIV), as well as its shedding. Thus, controlling HSV-2 infection and spread is of public health concern. Here, we review the diseases produced by herpes simplex viruses, the factors that modulate HSV-2 infection, the relationship between HSV-2 and HIV and novel therapeutic and prophylactic microbicides/antivirals under development to prevent infection and pathological outcomes produced by this virus. We also review mutations associated with HSV-2 resistance to common antivirals.
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Murphy K, Irvin SC, Herold BC. Research gaps in defining the biological link between HIV risk and hormonal contraception. Am J Reprod Immunol 2014; 72:228-35. [PMID: 24548147 DOI: 10.1111/aji.12209] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Accepted: 01/07/2014] [Indexed: 01/10/2023] Open
Abstract
Epidemiologic data suggest an association between depot medroxyprogesterone acetate (DMPA), a progesterone-based hormonal contraceptive, and increased risk of HIV acquisition and transmission. DMPA is highly effective and is among the most commonly used form of hormonal contraception in areas of high HIV prevalence. Thus, defining the biological mechanisms that contribute to the potential negative synergy between DMPA and HIV is key and may facilitate the identification of alternative contraceptive strategies. Proposed mechanisms include thinning or disruption of the cervicovaginal epithelial barrier, induction of mucosal inflammation, interference with innate and adaptive soluble and cellular immune responses, and/or alterations in the vaginal microbiome. DMPA may also indirectly increase the risk of HIV by promoting genital herpes or other sexually transmitted infections. However, there is a paucity of rigorous in vitro, animal model and clinical data to support these potential mechanisms highlighting the need for future research.
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Affiliation(s)
- Kerry Murphy
- Albert Einstein College of Medicine, Bronx, NY, USA
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9
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Kenyon C, Colebunders R, Buve A, Hens N. Partner-concurrency associated with herpes simplex virus 2 infection in young South Africans. Int J STD AIDS 2013; 24:804-12. [PMID: 23970590 DOI: 10.1177/0956462413482810] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Whilst much is known about the individual-level risk factors for herpes simplex virus 2 (HSV-2) infection, little is known about why only some populations develop generalized HSV-2 epidemics. This study aims to assess the extent to which partner-concurrency (a factor which operates at both the partnership- and network-level) may be responsible. We utilized multivariate logistic regression to analyse the relationship between HSV-2 seropositivity and potential risk factors in data from a representative cross-sectional survey of 14-24 year olds from a township in South Africa conducted in 1999. The overall prevalence of HSV-2 was 53.3% amongst women and 17% amongst men. For men, four factors remained significantly associated with HSV-2 infection in the multivariate regression analysis: total number of sex acts, being a migrant labourer, Zulu ethnicity and being human immunodeficiency virus (HIV) positive. For women, eight factors were associated with HSV-2 infection: increasing age, partner-concurrency (having a partner who had other partners), an older partner, total number of sex acts, using hormonal contraception, Xhosa ethnicity, syphilis seropositivity and being HIV positive. We conclude that partner-concurrency is associated with increased HSV-2 seropositivity in women.
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Affiliation(s)
- Chris Kenyon
- HIV/STD Unit, Institute of Tropical Medicine, University of Antwerp, Antwerp, Belgium
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10
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Zanger P, Nurjadi D, Gaile M, Gabrysch S, Kremsner PG. Hormonal contraceptive use and persistent Staphylococcus aureus nasal carriage. Clin Infect Dis 2012; 55:1625-32. [PMID: 22955426 DOI: 10.1093/cid/cis778] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Human nares colonized with Staphylococcus aureus are the most important reservoir for this pathogen. We studied the influence of sex and hormonal contraceptive use on persistent S. aureus nasal carriage. METHODS We conducted a cohort study in healthy volunteers and determined carriage status at baseline and again at follow-up by using the results of 2 swab samples at each time point. We applied logistic regression to analyze associations of interest. RESULTS At baseline, 266 of 1180 volunteers (22.5%) were classified as persistent nasal carriers. Compared with women not using hormonal contraceptives, women taking reproductive hormones (odds ratio [OR]. 1.88; 95% confidence interval [CI], 1.29-2.75; P = .001) and men (OR., 1.57; 95% CI, 1.08-2.28; P = .02) were more likely to be persistent carriers. These associations remained stable after adjusting for known risk factors of nasal carriage. Women taking hormonal contraceptives and being persistent carriers at baseline were more likely to remain carriers after a median follow-up time of 70 days than women not using such medication (OR, 3.25; 95% CI, 1.44-7.34; P = .005). No patterns of association could be observed between persistent carriage among women and type of progestin or dose of estrogen used. Assuming causality and using estimates from multivariable logistic regression, we approximated that 20% (95% CI, 2.4%-34.9%) of persistent nasal carriage among women represented by our sample is attributable to hormonal contraception (population-attributable fraction). CONCLUSIONS The widespread use of hormonal contraception may substantially increase the human S. aureus reservoir with potential impact on S. aureus infection and transmission.
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Affiliation(s)
- Philipp Zanger
- Institut für Tropenmedizin, Eberhard Karls Universität, Tübingen, Germany.
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11
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Ng BE, Rutherford GW, Broad AL, Moore DM. Antiviral therapy for genital herpes for prevention of HIV transmission. Hippokratia 2011. [DOI: 10.1002/14651858.cd006492.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Brian E Ng
- The University of British Columbia; School of Population and Public Health; Vancouver BC Canada
| | - George W Rutherford
- University of California, San Francisco; Global Health Sciences; 50 Beale Street Suite 1200 San Francisco California USA 94105
| | - Angela L Broad
- University of California, San Francisco; Global Health Sciences; 50 Beale Street Suite 1200 San Francisco California USA 94105
| | - David M Moore
- University of British Columbia; BC Centre for Excellence in HIV/AIDS; Vancouver British Columbia Canada
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Prevalence of specific herpes simplex virus-2 antibodies and associated factors in women of a rural town of Colombia. Trans R Soc Trop Med Hyg 2011; 105:232-8. [DOI: 10.1016/j.trstmh.2011.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2010] [Revised: 01/14/2011] [Accepted: 01/14/2011] [Indexed: 11/18/2022] Open
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13
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Epidemiology of Herpes Simplex Virus Type 2 Infection in Rural and Urban Burkina Faso. Sex Transm Dis 2011; 38:117-23. [DOI: 10.1097/olq.0b013e3181f0bef7] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Clemens SAC, Farhat CK. Soroprevalência de anticorpos contra vírus herpes simples 1-2 no Brasil. Rev Saude Publica 2010; 44:726-34. [DOI: 10.1590/s0034-89102010000400017] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2008] [Accepted: 12/08/2009] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Estimar a soroprevalência de anticorpos por vírus herpes simples (HSV-1 e HSV-2) e analisar fatores associados no Brasil. MÉTODOS: Estudo transversal realizado entre 1996 e 1997 em 1.090 indivíduos com idade entre um e 40 anos da população geral, em quatro diferentes regiões geográficas no Brasil. Foram analisadas amostras sangüíneas para detecção de anticorpos para HSV-1 e HSV-2 com teste tipo-específico Elisa. Foram descritas freqüências e proporções, comparadas entre grupos utilizando o teste de Fisher bilateral exato. Foi realizada análise de regressão logística para avaliar influência das variáveis sociodemográficas e histórico de DST, sobre a soroprevalência de HSV-1 e/ou HSV-2. RESULTADOS: As soroprevalências de anticorpos para HSV-1 e HSV-2, ajustadas por idade, foram 67,2% e 11,3% respectivamente, sem diferença quanto ao sexo e maiores na Região Norte. As soroprevalências aumentaram com a idade, e para HSV-2 o maior aumento ocorreu na adolescência e entre adultos jovens. Indivíduos soropositivos para HSV-1 apresentaram maior risco de serem positivos para HSV-2 (15,7%) quando comparados com os negativos para HSV-1 (4,7%). Na análise multivariada, o histórico de DST aumentou significativamente (OR=3,2) a probabilidade de soropositividade para HSV-2. CONCLUSÕES: As soroprevalências para HSV-1 e para HSV-2 variam com a idade e entre as regiões do Brasil. História pregressa de DST é importante fator de risco para aquisição de infecção por HSV-2.
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Affiliation(s)
- Sue Ann Costa Clemens
- Instituto de Pós-Graduação Médica Carlos Chagas, Brasil; Universidade Federal de São Paulo, Brasil
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Le HV, Schoenbach VJ, Herrero R, Hoang Pham AT, Nguyen HT, Nguyen TT, Muñoz N, Franceschi S, Vaccarella S, Parkin MD, Snijders PJF, Morrow RA, Smith JS. Herpes simplex virus type-2 seropositivity among ever married women in South and north Vietnam: a population-based study. Sex Transm Dis 2010; 36:616-20. [PMID: 19617867 DOI: 10.1097/olq.0b013e3181a8cde4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate herpes simplex virus type-2 (HSV-2) seropositivity and associated risk factors in Vietnamese women. METHODS Cross-sectional study with personal interviews and gynecological examinations among population-based samples of ever married women, aged 15 to 69 years, living in Ho Chi Minh City (HCMC) and Hanoi in 1997. Type-specific IgG antibodies against HSV-2 were detected using HerpeSelect ELISA (Focus Diagnostics). Adjusted prevalence ratios were estimated with log-binomial regression. RESULTS HSV-2 seroprevalence was higher in 1106 women from HCMC (30.8%, 95% CI: 28.1-33.4, age-standardized to 2000 world standard population) than in 1170 women from Hanoi (8.8%, 95% CI: 7.1-10.5). In HCMC, HSV-2 seroprevalence was higher for women who were not married, HPV DNA positive, current hormonal contraceptive users, or had a history of multiple sexual partners or spontaneous abortion. HCMC seroprevalence was inversely associated with educational attainment, age at first intercourse, and age at first pregnancy. In the multivariable model for HCMC, a trend of increasing HSV-2 seroprevalence with age was observed, and prevalence ratios were nearly identical to age-adjusted prevalence ratios for marital status, age at first pregnancy, and HPV DNA positivity. CONCLUSIONS HSV-2 was notably less prevalent in Hanoi than HCMC, where it was associated with traditional HSV-2 risk factors. These results are likely explained by socio-cultural, historical, economic, and demographic factors related to urban-rural and regional differences. Future population-based studies should include men and never-married women as a next step toward obtaining a more nearly complete picture of HSV-2 epidemiology in Vietnam.
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Affiliation(s)
- Hoa Van Le
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina 27599, USA
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Shust GF, Cho S, Kim M, Madan RP, Guzman EM, Pollack M, Epstein J, Cohen HW, Keller MJ, Herold BC. Female genital tract secretions inhibit herpes simplex virus infection: correlation with soluble mucosal immune mediators and impact of hormonal contraception. Am J Reprod Immunol 2009; 63:110-9. [PMID: 20015330 DOI: 10.1111/j.1600-0897.2009.00768.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
PROBLEM Female genital tract secretions inhibit herpes simplex virus (HSV) infection, however, the intra- and inter-subject variability, contribution of specific mediators, and impact of reproductive hormones have not been defined. METHOD of study Cervicovaginal lavage (CVL) (n = 89) obtained from nine cyclers and seven women on hormonal contraception (HC), who completed between three and eight weekly visits, were examined for anti-herpes simplex virus activity and concentrations of mediators. RESULTS The CVL inhibited HSV infection by a mean value of approximately 57% during the follicular or luteal phase, but only by 36% in hormonal contraceptive users. Human neutrophil peptides 1-3 (HNP1-3) (P = 0.03), IL-8 (P = 0.003), lactoferrin (P = 0.005), lysozyme (P = 0.003), IgA (P = 0.002), and IgG (P = 0.02) correlated with antiviral activity. Intra-subject and inter-subject variability was observed, suggesting that factors other than hormones contribute to innate defense. CONCLUSION Endogenous antimicrobial activity may provide a biomarker of healthy mucosal immunity and may be reduced in the setting of HC. However, larger prospective studies are needed.
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Affiliation(s)
- Gail F Shust
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY 10467, USA
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17
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Martin ET, Krantz E, Gottlieb SL, Magaret AS, Langenberg A, Stanberry L, Kamb M, Wald A. A pooled analysis of the effect of condoms in preventing HSV-2 acquisition. ACTA ACUST UNITED AC 2009; 169:1233-40. [PMID: 19597073 DOI: 10.1001/archinternmed.2009.177] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND The degree of effectiveness of condom use in preventing the transmission of herpes simplex virus 2 (HSV-2) is uncertain. To address this issue, we performed a large pooled analysis. METHODS We identified prospective studies with individual-level condom use data and laboratory-defined HSV-2 acquisition. Six studies were identified through a review of publications through 2007: 3 candidate HSV-2 vaccine studies, an HSV-2 drug study, an observational sexually transmitted infection (STI) incidence study, and a behavioral STI intervention study. Study investigators provided us individual-level data to perform a pooled analysis. Effect of condom use was modeled using a continuous percentage of sex acts during which a condom was used and, alternatively, using absolute numbers of unprotected sex acts. RESULTS A total of 5384 HSV-2-negative people at baseline contributed 2 040 894 follow-up days; 415 persons acquired laboratory-documented HSV-2 during follow-up. Consistent condom users (used 100% of the time) had a 30% lower risk of HSV-2 acquisition compared with those who never used condoms (hazard ratio [HR], 0.70; 95% confidence interval [CI], 0.40-0.94) (P = .01). Risk for HSV-2 acquisition increased steadily and significantly with each unprotected sex act (HR, 1.16; 95% CI, 1.08-1.25) (P < .001). Condom effectiveness did not vary by gender. CONCLUSIONS To our knowledge, this is the largest analysis using prospective data to assess the effect of condom use in preventing HSV-2 acquisition. Although the magnitude of protection was not as large as has been observed with other STIs, we found that condoms offer moderate protection against HSV-2 acquisition in men and women.
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Affiliation(s)
- Emily T Martin
- Departments of Epidemiology, University of Washington, Seattle, USA.
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Rodrigues J, Grinsztejn B, Bastos FI, Velasque L, Luz PM, de Souza CTV, Georg I, Pilotto JH, Veloso VG. Seroprevalence and factors associated with herpes simplex virus type 2 among HIV-negative high-risk men who have sex with men from Rio de Janeiro, Brazil: a cross-sectional study. BMC Infect Dis 2009; 9:39. [PMID: 19335922 PMCID: PMC2670309 DOI: 10.1186/1471-2334-9-39] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2008] [Accepted: 04/01/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Herpes simplex virus type 2 (HSV-2) is the leading cause of genital ulcer disease in developing countries, including Brazil, and is especially prevalent among men who have sex with men (MSM). HSV-2 infection represents a risk factor for the acquisition and transmission of other sexually transmitted diseases. The goal of the present cross-sectional study was to estimate HSV-2 seroprevalence and to determine the factors associated with HSV-2 seropositivity in HIV-negative high-risk MSM from Rio de Janeiro, Brazil. METHODS Stored sera were tested to estimate HSV-2 seroprevalence, while socio-demographic and sexual behavior data were used to measure associations between risk factors and HSV-2 seropositivity. Using the Poisson regression model with robust variance, prevalence ratios (PR) were used to estimate de degree of association between risk factors and HSV-2 seropositivity in bivariate and multivariate analyses. RESULTS Seroprevalence of HSV-2 was of 45.7% (184 out of 403). Factors independently associated with HSV-2 seroprevalence in the multivariate model were: older age (>or= 26 years, PR: 1.41 95% Confidence Interval: 1.11-1.78), non-white race (PR: 1.32 95%CI: 1.06-1.64), positive serology for syphilis (PR: 1.65 95%CI: 1.33-2.05), positive serology for hepatitis B (PR: 1.25 95%CI: 0.99-1.57), stable male partner in the past 6 months (PR: 1.42 95%CI: 1.12-1.79), and unprotected anal sex with a stable female partner (PR: 1.46 95%CI: 1.05-2.04) in the 6 months preceding the cross-sectional assessment. CONCLUSION The present study made evident a high prevalence of HSV-2 infection in a sample of HIV-negative high-risk MSM from Rio de Janeiro. This finding indicates the need and urgency for implementing integrated programs for the prevention of HSV-2 and other sexually transmitted diseases, and, in particular, programs targeting high-risk MSM.
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Affiliation(s)
- Junia Rodrigues
- Instituto de Pesquisa Clínica Evandro Chagas (IPEC), Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
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Highly effective contraception and acquisition of HIV and other sexually transmitted infections. Best Pract Res Clin Obstet Gynaecol 2009; 23:263-84. [DOI: 10.1016/j.bpobgyn.2008.11.004] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2008] [Revised: 11/13/2008] [Accepted: 11/14/2008] [Indexed: 11/22/2022]
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20
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Arama V, Vladareanu R, Mihailescu R, Streinu Cercel A, Mihai C, Hristea A, Iosipenco M, Arama SS, Rabilloud M. Seroprevalence and risk factors associated with herpes simplex virus infection among pregnant women. J Perinat Med 2008; 36:206-12. [PMID: 18576929 DOI: 10.1515/jpm.2008.046] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To estimate the type-specific seroprevalence and identify the risk factors associated with herpes simplex virus (HSV)-2 infection in pregnant women in Bucharest, Romania. METHODS A prospective survey was conducted in 452 subjects, aged 15-39 years, at the Elias Hospital, during the years 2004-2005. We evaluated serum IgG anti-bodies to HSV-1 and HSV-2 using the HerpeSelect ELISA test. All subjects completed an epidemiological questionnaire. RESULTS Seroprevalence was 87.3% and 15.1% for HSV-1 and HSV-2, respectively. The risk factors for HSV-2 infection were lower level of education and a greater number of sexual partners. Elementary school and high-school graduates were 6.28 and 2.26 times more exposed than University graduates. Having 2-3 partners and more than three partners was associated with 2.43 and 4.26 times the risk of acquiring HSV-2, compared with having one partner. CONCLUSIONS In pregnant women, HSV-1 seroprevalence was higher than in Western Europe but similar to that in Eastern Europe. HSV-2 seroprevalence was within European ranges. Both were lower than in the USA. Risk factors for HSV-2 infection may lead to prevention programs.
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Affiliation(s)
- Victoria Arama
- Department Adults 3 of National Institute of Infectious Diseases Professor Dr. Matei Bals, Bucharest, Romania
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Type-Specific Seroprevalence of Herpes Simplex Virus Type 2 and Associated Risk Factors in Middle-Aged Women From 6 Countries: The IARC Multicentric Study. Sex Transm Dis 2007. [DOI: 10.1097/olq.0b013e31811f4118] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Baeten JM, Lavreys L, Overbaugh J. The influence of hormonal contraceptive use on HIV-1 transmission and disease progression. Clin Infect Dis 2007; 45:360-9. [PMID: 17599316 DOI: 10.1086/519432] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2007] [Accepted: 04/04/2007] [Indexed: 11/03/2022] Open
Abstract
Women account for nearly one-half of new human immunodeficiency virus type 1 (HIV-1) infections worldwide, including the majority of infections in Africa. Biological and epidemiological studies suggest that hormonal contraceptive use could influence susceptibility to HIV-1, as well as infectivity and disease progression for those who become infected. However, not all studies have shown this relationship, and many questions remain. Safe and effective contraceptive choices are essential for women with and at risk for HIV-1 infection. Thus, understanding the effect, if any, of hormonal contraception on HIV-1 disease among women is a public health priority.
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Affiliation(s)
- Jared M Baeten
- Department of Medicine, University of Washington, Seattle, WA, USA.
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Davies SC, Taylor JA, Sedyaningsih-Mamahit ER, Gunawan S, Cunningham AL, Mindel A. Prevalence and risk factors for herpes simplex virus type 2 antibodies among low- and high-risk populations in Indonesia. Sex Transm Dis 2007; 34:132-8. [PMID: 16868530 DOI: 10.1097/01.olq.0000230427.01727.80] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES/GOAL Data on prevalence of herpes simplex virus type 2 (HSV-2) infections are limited in Asia. This study investigated the seroprevalence of, and risk factors for, antibodies to HSV-2 among low- and high-risk, predominantly asymptomatic populations in Indonesia. STUDY DESIGN We screened women attending maternal and child health, obstetric, gynecology, and sexually transmitted infection (STI) clinics; men attending STI clinics; and female sex workers (FSWs) for type-specific HSV-2 antibodies using the HerpesSelect 2 enzyme-linked immunosorbent assay IgG and Western blot. RESULTS HSV-2 antibodies were detected in 153 of 176 FSWs (86.9%; 95% confidence interval [CI], 81.0-91.5); increasing age was the only significant independent risk factor (odds ratio [OR], 1.15; 95% CI, 1.06-1.24; P = 0.001). Among non-sex worker females, HSV-2 antibodies were detected in 78 of 418 (18.7%; 95% CI, 15.0-22.7); significant independent associations were any contraceptive use (OR, 2.24, 95% CI = 1.33-3.85, P = 0.003), symptoms or signs of genital ulcer (OR, 2.69; 95% CI, 1.27-5.70; P = 0.01) and younger age of sexual debut (OR, 0.92; 95% CI, 0.86-0.99; P = 0.03). HSV-2 antibodies were detected in 25 of 116 men (21.6%; 95% CI, 14.5-30.1). CONCLUSIONS HSV-2 seroprevalence reported here is in the upper range of that reported in nearby regions. Health promotion is needed to encourage affected individuals to recognize symptoms of genital herpes and seek care and advice on reducing transmission. The high seroprevalence among FSWs has potentially serious implications for the HIV epidemic in Indonesia.
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Affiliation(s)
- Stephen C Davies
- Sexual Health Service, Royal North Shore Hospital, St. Leonards, NSW 2065, Australia.
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Santos FC, de Oliveira SA, Setúbal S, Camacho LAB, Faillace T, Leite JPG, Velarde LGC. Seroepidemiological study of herpes simplex virus type 2 in patients with the acquired immunodeficiency syndrome in the city of Niterói, Rio de Janeiro, Brazil. Mem Inst Oswaldo Cruz 2006; 101:315-9. [PMID: 16862329 DOI: 10.1590/s0074-02762006000300016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2006] [Accepted: 03/29/2006] [Indexed: 11/22/2022] Open
Abstract
This study was designed to determine the seroprevalence of herpes simplex virus type 2 (HSV-2) and to evaluate its association with age, sex as well as other demographic and behavioural factors in 150 human immunodeficiency virus (HIV) positive adults patients attending the general medical outpatient ward for routine care of Niterói, state of Rio de Janeiro, Brazil. Serum samples were screened for HSV-2 antibodies using an indirect ELISA. Eighty-three patients were men (mean age: 38.8) and 67 were women (mean age: 35.4). The estimated prevalence of HSV-2 was 52% (95% CI: 44-60%) and it was higher among men (53%) than among women (50.7%). Overall, the age of first sexual intercourse and past history of genital herpes were associated with HSV-2 seropositivity. Analysis by gender disclosed significant association of number of lifetime sex partners only among men. Although HSV-2 antibodies were frequent in the study group, genital herpes was reported by 21.8% of the HSV-2 positive subjects, indicating low awareness of the HSV-2 infection. These results may have public health importance for Brazil as the high rate of HSV-2 infection may act as a cofactor of HIV transmission.
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Affiliation(s)
- Flávia Cunha Santos
- Disciplina de Doenças Infecciosas e Parasitárias, Hospital Universitário Antonio Pedro, Niterói, RJ, 24030-210, Brasil
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Castellsagué X, Díaz M, de Sanjosé S, Muñoz N, Herrero R, Franceschi S, Peeling RW, Ashley R, Smith JS, Snijders PJF, Meijer CJLM, Bosch FX. Worldwide human papillomavirus etiology of cervical adenocarcinoma and its cofactors: implications for screening and prevention. J Natl Cancer Inst 2006; 98:303-15. [PMID: 16507827 DOI: 10.1093/jnci/djj067] [Citation(s) in RCA: 397] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Most cancers of the uterine cervix are squamous cell carcinomas. Although the incidence of such carcinomas of the uterine cervix has declined over time, that of cervical adenocarcinoma has risen in recent years. The extent to which human papillomavirus (HPV) infection and cofactors may explain this differential trend is unclear. METHODS We pooled data from eight case-control studies of cervical cancer that were conducted on three continents. A total of 167 case patients with invasive cervical adenocarcinoma (112 with adenocarcinoma and 55 with adenosquamous carcinoma) and 1881 hospital-based control subjects were included. HPV DNA was analyzed in cervical specimens with the GP5+/6+ general primer system followed by type-specific hybridization for 33 HPV genotypes. Blood samples were analyzed for chlamydial and herpes simplex virus 2 (HSV-2) serology. Multivariable unconditional logistic regression modeling was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs). All tests of statistical significance were two-sided. RESULTS The adjusted overall odds ratio for cervical adenocarcinoma in HPV-positive women compared with HPV-negative women was 81.3 (95% CI = 42.0 to 157.1). HPV 16 and HPV 18 were the two most commonly detected HPV types in case patients and control subjects. These two types were present in 82% of the patients. Cofactors that showed clear statistically significant positive associations with cervical adenocarcinoma overall and among HPV-positive women included never schooling, poor hygiene, sexual behavior-related variables, long-term use of hormonal contraception, high parity, and HSV-2 seropositivity. Parity had a weaker association with adenocarcinoma and only among HPV-positive women. Use of an intrauterine device (IUD) had a statistically significant inverse association with risk of adenocarcinoma (for ever use of an IUD compared with never use, OR = .41 [95% CI = 0.18 to 0.93]). Smoking and chlamydial seropositivity were not associated with disease. CONCLUSIONS HPV appears to be the key risk factor for cervical adenocarcinoma. HPV testing in primary screening using current mixtures of HPV types and HPV vaccination against main HPV types should reduce the incidence of this cancer worldwide.
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Affiliation(s)
- Xavier Castellsagué
- Institut d'Investigació Biomèdica de Bellvitge, Cancer Epidemiology and Registration Unit, Institut Català d'Oncologia. L'Hospitalet de Llobregat, Barcelona, Spain.
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Pérez LO, Barbisan G, Abba MC, Laguens RM, Dulout FN, Golijow CD. Herpes simplex virus and human papillomavirus infection in cervical disease in Argentine women. Int J Gynecol Pathol 2006; 25:42-7. [PMID: 16306783 DOI: 10.1097/01.pgp.0000177996.30427.2b] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The aim of the present study was to determine that prevalence of herpes simplex virus (HSV) type 1 and 2 in cervical samples from Argentine women and to assess the role of HSV-2 in cervical cancer. A sample of 79 normal and 200 neoplastic cervical tissues (35 invasive cervical carcinomas, 75 high-grade squamous intraepithelial lesions, 79 low-grade squamous intraepithelial lesions and 11 abnormal squamous cells of undermined significance) was analyzed for herpes simplex and human papillomavirus DNA using the polymerase chain reaction method. Viral genotyping was performed by single strand conformation polymorphisms and restriction fragment length polymorphisms. The overall prevalence of HSV was 21.5% in controls and 29% in cases. Among women with normal cytology, herpes simplex prevalence in HPV positive (20.8%) women was approximately the same as in negative (21.8%) women. HPV- and age- adjusted ORs of high-grade squamous intraepithelial lesions and invasive cervical carcinomas for HSV-2 were 1.4 (p = 0.6) and 1.6 (p = 0.5), respectively. The obtained results indicated that herpes simplex virus may not be involved in cervical cancer development. Future investigations are needed to provided conclusive evidence on the role of this pathogen in cervical cancer.
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Affiliation(s)
- Luis Orlando Pérez
- Departamento de Carcinogénesis, Centro de Investigaciones en Genética Básica y Aplicada, Facultad de Ciencias Veterinarias, Universidad Nacional de La Plata, La Plata, Argentina
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Mohllajee AP, Curtis KM, Martins SL, Peterson HB. Hormonal contraceptive use and risk of sexually transmitted infections: a systematic review. Contraception 2005; 73:154-65. [PMID: 16413846 DOI: 10.1016/j.contraception.2005.08.012] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2005] [Accepted: 08/11/2005] [Indexed: 11/15/2022]
Abstract
Previous research has suggested that hormonal contraceptive users, compared with nonusers, may be at increased risk for acquiring sexually transmitted infections (STIs). We searched the MEDLINE and EMBASE databases for all articles from January 1966 through February 2005 for evidence relevant to all hormonal contraceptives and STIs (including cervical chlamydial and gonococcal infection, human papillomavirus, trichomoniasis, herpes and syphilis). We used standard abstract forms and grading systems to summarize and assess the quality of 83 identified studies. Studies of combined oral contraceptive and depot medroxyprogesterone use generally reported positive associations with cervical chlamydial infection, although not all associations were statistically significant. For other STIs, the findings suggested no association between hormonal contraceptive use and STI acquisition, or the results were too limited to draw any conclusions. Evidence was generally limited in both amount and quality, including inadequate adjustment for confounding, lack of appropriate control groups and small sample sizes. The observed positive associations may be due to a true association or to bias, such as differential exposure to STIs by contraceptive use or increased likelihood of STI detection among hormonal contraceptive users.
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Affiliation(s)
- Anshu P Mohllajee
- Centers for Disease Control and Prevention, Division of Reproductive Health, WHO Collaborating Center in Reproductive Health, Atlanta, GA 30341, USA
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Smith JS, Bosetti C, Muñoz N, Herrero R, Bosch FX, Eluf-Neto J, Meijer CJLM, Van Den Brule AJC, Franceschi S, Peeling RW. Chlamydia trachomatis and invasive cervical cancer: a pooled analysis of the IARC multicentric case-control study. Int J Cancer 2004; 111:431-9. [PMID: 15221973 DOI: 10.1002/ijc.20257] [Citation(s) in RCA: 179] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
To determine whether Chlamydia trachomatis infection is consistently associated with an increased risk of invasive cervical carcinoma (ICC) after accounting for the strong effect of human papillomavirus (HPV) infection, a case-control study of 1,238 cases of ICC and 1,100 control women from 7 countries was carried out (hospital-based studies in Thailand, the Philippines, Morocco, Peru, Brazil and population-based studies in Colombia and Spain, all coordinated by the International Agency for Research on Cancer, Lyon, France). C. trachomatis serum antibody detection was made by means of a microfluorescence assay. Among HPV DNA-positive cases and controls, the risk of squamous cell ICC was elevated in C. trachomatis seropositive women (OR = 1.8; 95% CI = 1.2-2.7) after adjustment for age, center, oral contraceptive use, history of Pap smears, number of full-term pregnancies and herpes simplex virus 2 seropositivity. The effect of C. trachomatis seropositivity on squamous cell ICC risk increased with increasing C. trachomatis antibody titers and was higher in women under 55 years of age. C. trachomatis antibodies were not associated with adeno- or adenosquamous cell carcinoma (OR = 1.0; 95% CI = 0.53-1.9) in HPV DNA-positive women. An association of C. trachomatis with squamous cell ICC was found among all cases and control women with or without adjustment for HPV.
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Rodríguez AC, Castle PE, Smith JS, Bratti C, Hildesheim A, Schiffman M, Viscidi R, Burk RD, Ashley RL, Castellsagué X, Herrero R. A population based study of herpes simplex virus 2 seroprevalence in rural Costa Rica. Sex Transm Infect 2004; 79:460-5. [PMID: 14663121 PMCID: PMC1744764 DOI: 10.1136/sti.79.6.460] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To determine seroprevalence and determinants of herpes simplex virus 2 (HSV-2) seropositivity, in a random sample of a population based cohort of 10 049 women of Guanacaste, Costa Rica, using a highly sensitive and specific serological assay. METHODS Seroprevalence was determined by a type specific HSV-2 ELISA assay in an age stratified random sample of 1100 women. Univariate and multivariate logistic regression was used to calculate odds ratios and 95% confidence intervals for risk factors of seropositivity. RESULTS Overall age adjusted HSV-2 seroprevalence was 38.5% (95% CI, 37.5 to 39.5), and it was strongly associated with increasing age (p(Trend<0.0001)), both among monogamous women and women with multiple sexual partners. A greater number of lifetime sexual partners increased the risk of seropositivity, with a 28.2% (95% CI, 24.4 to 32.2) seroprevalence among monogamous women and 75% (95% CI, 65.6 to 83.0) seroprevalence for those with four or more partners (OR = 7.6 95% CI, 4.7 to 12.4 p(Trend<0.0001)). Barrier contraceptive use was negatively associated with HSV-2 seropositivity (OR 0.54, 95% CI, 0.31 to 0.94). Women with antibodies against HPV 16, 18, or 31 were 1.6 times more likely to be HSV-2 seropositive (OR 1.6, 95% CI, 1.2 to 2.1). CONCLUSIONS HSV-2 infection is highly endemic in Guanacaste, even among lifetime monogamous women, suggesting a role of male behaviour in the transmission of the infection. Until vaccination against HSV-2 is available, education to prevent high risk sexual behaviour and the use of condoms appear as preventive measures against HSV-2.
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Affiliation(s)
- A C Rodríguez
- Guanacaste Project, Costa Rica Foundation for Health Sciences, San José, Costa Rica
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Kapiga SH, Sam NE, Shao JF, Masenga EJ, Renjifo B, Kiwelu IE, Manongi R, Fawzi WW, Essex M. Herpes simplex virus type 2 infection among bar and hotel workers in northern Tanzania: prevalence and risk factors. Sex Transm Dis 2003; 30:187-92. [PMID: 12616132 DOI: 10.1097/00007435-200303000-00001] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Type-specific serological tests have allowed for a better understanding of the epidemiology of herpes simplex virus type 2 (HSV-2) infection in Africa. GOAL The goal was to determine risk factors for HSV-2 among bar and hotel workers in Moshi, Tanzania. STUDY DESIGN A cross-sectional study was conducted involving 515 workers in randomly selected bars and hotels in Moshi. RESULTS The seroprevalence of HSV-2 was 43.5%. Women were more likely to be HSV-2-seropositive than men (age-adjusted OR = 3.8; 95% CI = 2.5-5.8). In multivariate analyses, age was positively associated with HSV-2 in both women and men. HIV-1-seropositive women had a significantly increased risk of HSV-2 infection (adjusted OR = 2.8; 95% CI = 1.5-5.1). Other predictors of HSV-2 were religion and sexual behavior for women and level of education, frequency of alcohol use, and concurrent partners for men. CONCLUSION The most common genital infection was that with HSV-2. Control of HSV-2 might be an important strategy for HIV-1 infection prevention in this population.
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Affiliation(s)
- Saidi H Kapiga
- Department of Population and International Health, Harvard School of Public Health, Boston, Massachusetts 02115, USA.
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31
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Smith JS, Robinson NJ. Age-specific prevalence of infection with herpes simplex virus types 2 and 1: a global review. J Infect Dis 2002; 186 Suppl 1:S3-28. [PMID: 12353183 DOI: 10.1086/343739] [Citation(s) in RCA: 562] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Information on age- and sex-specific prevalence of herpes simplex virus (HSV) types 2 and 1 infections is essential to optimize genital herpes control strategies, which increase in importance because accumulating data indicate that HSV-2 infection may increase acquisition and transmission of human immunodeficiency virus. This review summarizes data from peer-reviewed publications of type-specific HSV seroepidemiologic surveys. HSV-2 prevalence is, in general, highest in Africa and the Americas, lower in western and southern Europe than in northern Europe and North America, and lowest in Asia. HSV-2 and -1 prevalence, overall and by age, varies markedly by country, region within country, and population subgroup. Age-specific HSV-2 prevalence is usually higher in women than men and in populations with higher risk sexual behavior. HSV-2 prevalence has increased in the United States but national data from other countries are unavailable. HSV-1 infection is acquired during childhood and adolescence and is markedly more widespread than HSV-2 infection. Further studies are needed in many geographic areas.
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Affiliation(s)
- Jennifer S Smith
- International Agency for Research on Cancer (IARC), Unit of Field and Intervention Studies, 69372 Lyon, France.
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Abstract
Human papillomavirus (HPV) is a common viral infection of squamous epithelial tissues, but its importance has only recently been recognised by the medical community. HPVs are now realised to consist of many genotypes and are associated with a diverse spectrum of clinical manifestations. Within the genital tract, some diseases have been recognised since antiquity; for example, genital warts which are caused by HPV types distinct from those causing genital cancer. However, others (such as cervical cancer), although recognised centuries ago as linked to sexual activity, have only been associated with oncogenic HPVs relatively recently, with the tools of molecular biology. We now understand that genital HPV infections are the most common sexually transmitted viral infections, are largely transient, asymptomatic and of no consequence. This virus manifests as more than just benign warts. Chronic carriage of with oncogenic genotypes (over years and in a minority of patients), together with other cofactors (host and/or exogenous) in complex pathways not totally understood, result in severe dysplasia or, ultimately, carcinogenesis. As it takes time for precursor lesions to develop and there are effective screening programmes for their detection and treatment, HPV-related neoplastic disease of the cervix is largely a preventable reproductive health issue of women. Yet, on a global scale, cervical cancer is the second most common cancer of women, with the majority of cases occurring in developing countries. Although HPV is noncultivatable by traditional diagnostic virological methods, successfully applied molecular biology techniques have underpinned development of vaccines which are now in phase II/III clinical trials. Successful vaccination ultimately has the greatest potential to impact upon the global burden of disease from genital HPV infection. However, the outcome from reduction in incidence of dysplasia and neoplasia will take years to eventuate; consequently, various cervical cancer prevention strategies still need to be endorsed and maintained in the meantime.
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Affiliation(s)
- Suzanne M Garland
- Department of Microbiology and Infectious Diseases, The Royal Women's and The Royal Children's Hospitals, Women's and Children's Health, Carlton, Victoria, Australia.
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