From the Department of Obstetrics and Gynecology.
Department of Biostatistics.
Sex Transm Dis. 2019 Jan;46(1):58-62. doi: 10.1097/OLQ.0000000000000907.
The effect of female sex hormones on herpes simplex virus (HSV)-2 shedding and lesion frequency is poorly understood. Previous studies suggest that hormonal contraception may increase the frequency of HSV-2 shedding.
We studied HSV-2 seropositive women who performed daily genital swabbing for HSV DNA and completed diaries for genital lesions and menses. We used Poisson mixed effects models to determine if HSV detection varied throughout the menstrual cycle, or in response to hormonal contraception. We used the Wilcoxon signed-rank test and rank-sum test to determine if lesion frequency differed by cycle phase or hormonal contraceptive use.
In 189 women aged 19 to 46 years who collected swabs on 10,715 days and were not using hormonal contraception, HSV-2 DNA was detected on 20.9% of days in the follicular phase and 17.8% of days in the luteal phase (rate ratio, 1.19; 95% confidence interval, 1.03-1.37, P = 0.02). Genital lesions did not differ in the follicular versus luteal phase (12.8% vs. 10.7%, P = 0.07). In analyses of hormonal contraception, including 244 women, HSV-2 DNA was detected on 19.0% of days for women not using hormonal contraception and 18.3% of days for those using hormonal contraception (P = 0.50). Lesions were present on 11.1% of days for women not using hormonal contraception, and 8.7% of days for those using hormonal contraception (P = 0.66).
In women with genital HSV-2 infection who are not using hormonal contraception, the follicular phase of the cycle may be associated with a higher frequency of HSV-2 shedding compared to the luteal phase. Lesion frequency is similar during the 2 menstrual phases. Hormonal contraception use was not observed to affect genital HSV-2 DNA detection or lesions.
女性性激素对单纯疱疹病毒（HSV）-2 脱落和病变频率的影响知之甚少。先前的研究表明，激素避孕可能会增加 HSV-2 脱落的频率。
我们研究了生殖器单纯疱疹病毒 2 血清阳性的女性，她们每天进行生殖器拭子采样以检测 HSV DNA，并完成生殖器病变和月经的日记。我们使用泊松混合效应模型来确定 HSV 检测是否在整个月经周期中或对激素避孕有变化。我们使用 Wilcoxon 符号秩检验和秩和检验来确定病变频率是否因周期阶段或激素避孕使用而不同。
在 189 名年龄在 19 至 46 岁之间的女性中，她们在 10715 天内采集了拭子，并且没有使用激素避孕，在卵泡期每天有 20.9%的日子检测到 HSV-2 DNA，在黄体期每天有 17.8%的日子检测到 HSV-2 DNA（率比，1.19；95%置信区间，1.03-1.37，P=0.02）。生殖器病变在卵泡期和黄体期之间没有差异（12.8%对 10.7%，P=0.07）。在包括 244 名女性的激素避孕分析中，未使用激素避孕的女性每天有 19.0%的日子检测到 HSV-2 DNA，而使用激素避孕的女性每天有 18.3%的日子检测到 HSV-2 DNA（P=0.50）。未使用激素避孕的女性有 11.1%的日子出现病变，而使用激素避孕的女性有 8.7%的日子出现病变（P=0.66）。
在未使用激素避孕的生殖器单纯疱疹病毒 2 感染女性中，与黄体期相比，卵泡期可能与 HSV-2 脱落的更高频率相关。在两个月经阶段，病变频率相似。未观察到激素避孕使用影响生殖器单纯疱疹病毒 2 DNA 检测或病变。
