Kaul Rupert, Nagelkerke Nico J, Kimani Joshua, Ngugi Elizabeth, Bwayo Job J, Macdonald Kelly S, Rebbaprgada Anu, Fonck Karolien, Temmerman Marleen, Ronald Allan R, Moses Stephen
Department of Medical Microbiology, University of Nairobi, Kenya.
J Infect Dis. 2007 Dec 1;196(11):1692-7. doi: 10.1086/522006. Epub 2007 Oct 25.
Prevalent herpes simplex virus type 2 (HSV-2) infection increases human immunodeficiency virus acquisition. We hypothesized that HSV-2 infection might also predispose individuals to acquire other common sexually transmitted infections (STIs).
We studied the association between prevalent HSV-2 infection and STI incidence in a prospective, randomized trial of periodic STI therapy among Kenyan female sex workers. Participants were screened monthly for infection with Neisseria gonorrhoeae and Chlamydia trachomatis, and at least every 6 months for bacterial vaginosis (BV) and infection with Treponema pallidum, Trichomonas vaginalis, and/or HSV-2.
Increased prevalence of HSV-2 infection and increased prevalence of BV were each associated with the other; the direction of causality could not be determined. After stratifying for sexual risk-taking, BV status, and antibiotic use, prevalent HSV-2 infection remained associated with an increased incidence of infection with N. gonorrhoeae (incidence rate ratio [IRR], 4.3 [95% confidence interval {CI}, 1.5-12.2]), T. vaginalis (IRR, 2.3 [95% CI, 1.3-4.2]), and syphilis (IRR, 4.7 [95% CI, 1.1-19.9]). BV was associated with increased rates of infection with C. trachomatis (IRR, 2.1 [95% CI, 1.1-3.8]) and T. vaginalis (IRR, 8.0 [95% CI, 3.2-19.8]). CONCLUSION; Increased prevalences of HSV-2 infection and BV were associated with each other and also associated with enhanced susceptibility to an overlapping spectrum of other STIs. Demonstration of causality will require clinical trials that suppress HSV-2 infection, BV, or both.
单纯疱疹病毒2型（HSV-2）感染率的上升会增加人类免疫缺陷病毒的感染几率。我们推测HSV-2感染可能也会使个体更容易感染其他常见的性传播感染（STIs）。
我们在一项针对肯尼亚女性性工作者的定期性传播感染治疗的前瞻性随机试验中，研究了HSV-2感染率与性传播感染发病率之间的关联。参与者每月接受淋病奈瑟菌和沙眼衣原体感染筛查，至少每6个月接受细菌性阴道病（BV）以及梅毒螺旋体、阴道毛滴虫和/或HSV-2感染筛查。
HSV-2感染率的上升与BV患病率的上升相互关联；因果关系方向无法确定。在对性行为风险、BV状态和抗生素使用进行分层后，HSV-2感染率仍然与淋病奈瑟菌感染发病率的增加相关（发病率比值比[IRR]，4.3[95%置信区间{CI}，1.5-12.2]）、阴道毛滴虫感染（IRR，2.3[95%CI，1.3-4.2]）和梅毒感染（IRR，4.7[95%CI，1.1-19.9]）。BV与沙眼衣原体感染率的增加（IRR，2.1[95%CI，1.1-3.8]）和阴道毛滴虫感染率的增加（IRR，8.0[95%CI，3.2-19.8]）相关。结论：HSV-2感染率和BV患病率的上升相互关联，并且与对其他一系列性传播感染的易感性增强也相关。要证明因果关系需要进行抑制HSV-2感染、BV或两者的临床试验。
