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Hormonal contraceptives, BV up HSV-2 shedding.(Gynecology)
BETHESDA, MD. -- The use of hormonal contraception is among the factors associated with increased viral shedding among women with genital herpes simplex virus type-2 infections, Sharon L. Hillier, Ph.D., said at a conference on vul-vovaginal diseases.
Women who have recently been infected with HSV-2 and those with bacterial vaginosis (BV) have also been found to have greater viral shedding, said Dr. Hillier, director, reproductive infectious disease research, Magee-Womens Hospital, Pittsburgh. Shedding decreases over time after the primary episode.
Other women at risk for increased shedding include younger, pregnant, or the immunocompromised, and especially those who are HIV infected, she added.
The data on whether hormonal contraceptives are associated with increased shedding in this population have been mixed, she said, citing one study finding an association and two others, which found no such association.
But a study published in May that followed 330 HSV-2 seropositive women at 4-month intervals for 1 year, for a total of 956 visits, found a twofold increased risk of shedding among hormonal contraceptive users. At each visit, vaginal swab specimens were collected and tested for BV, yeast, group B streptococcus, and HSV-2 DNA, according to Thomas L. Cherpes, M.D., and associates at the University of Pittsburgh (Clin. Infect. Dis. 2005;40:1422-8).
A total of 95% of the women did not know they had herpes, noted Dr. Hillier, one of the study's authors and professor of obstetrics, gynecology, and reproductive sciences and of molecular genetics and biochemistry at the university.
Like other investigators, they found shedding increased threefold in those who were infected in the previous ...
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