Allahna Esber1, Rodolfo D Vicetti Miguel2, Thomas L Cherpes2, Mark A Klebanoff3, Maria F Gallo1, Abigail Norris Turner4. 1. Division of Epidemiology. 2. Department of Microbial Infection and Immunity Department of Obstetrics and Gynecology. 3. Department of Pediatrics Research Institute at Nationwide Children's Hospital, Columbus, Ohio. 4. Division of Infectious Diseases, Department of Internal Medicine, Ohio State University.
Abstract
BACKGROUND: Bacterial vaginosis (BV) is a perturbation of vaginal flora characterized by reduced levels of lactobacilli and concomitant overgrowth of anaerobic bacterial species. BV is highly prevalent and associated with multiple adverse outcomes, including enhanced human immunodeficiency virus transmission. Because recent reports reveal that herpes simplex virus type 2 (HSV-2) infection may increase BV risk, we initiated a systematic review and meta-analysis of the link between HSV-2 infection and BV. METHODS: We searched the MEDLINE, EMBASE, and CENTRAL databases to identify articles posted before 1 December 2014. Two screeners independently reviewed the titles and abstracts of all identified articles, reviewed the full text of articles deemed potentially eligible, and extracted data from 14 cross-sectional and 3 prospective studies. Using random-effects models, we computed separate pooled estimates for cross-sectional and prospective studies. RESULTS: The pooled odds ratio for cross-sectional studies was 1.60 (95% confidence interval, 1.32-1.94). Stronger support for the causal effect of HSV-2 infection on BV risk was revealed by the summary relative risk for the prospective studies, which was 1.55 (95% confidence interval, 1.30-1.84), with minimal heterogeneity (I(2) = 0). CONCLUSIONS: These analyses imply that HSV-2 infection is an important BV risk factor. Pharmacologic HSV-2 suppression may reduce BV incidence and BV-associated adverse events.
BACKGROUND:Bacterial vaginosis (BV) is a perturbation of vaginal flora characterized by reduced levels of lactobacilli and concomitant overgrowth of anaerobic bacterial species. BV is highly prevalent and associated with multiple adverse outcomes, including enhanced human immunodeficiency virus transmission. Because recent reports reveal that herpes simplex virus type 2 (HSV-2) infection may increase BV risk, we initiated a systematic review and meta-analysis of the link between HSV-2 infection and BV. METHODS: We searched the MEDLINE, EMBASE, and CENTRAL databases to identify articles posted before 1 December 2014. Two screeners independently reviewed the titles and abstracts of all identified articles, reviewed the full text of articles deemed potentially eligible, and extracted data from 14 cross-sectional and 3 prospective studies. Using random-effects models, we computed separate pooled estimates for cross-sectional and prospective studies. RESULTS: The pooled odds ratio for cross-sectional studies was 1.60 (95% confidence interval, 1.32-1.94). Stronger support for the causal effect of HSV-2 infection on BV risk was revealed by the summary relative risk for the prospective studies, which was 1.55 (95% confidence interval, 1.30-1.84), with minimal heterogeneity (I(2) = 0). CONCLUSIONS: These analyses imply that HSV-2 infection is an important BV risk factor. Pharmacologic HSV-2 suppression may reduce BV incidence and BV-associated adverse events.
Authors: Abigail N Turner; Patricia Carr Reese; Pai Lien Chen; Cynthia Kwok; Rebecca D Jackson; Mark A Klebanoff; Raina N Fichorova; Tsungai Chipato; Charles S Morrison Journal: Am J Obstet Gynecol Date: 2016-03-02 Impact factor: 8.661
Authors: Payal Chakraborty; Alison H Norris; Sarah Huber-Krum; Sarah Garver; Robert B Hood; Venson Banda; Allahna Esber; Carr Reese Patricia; Robert Krysiak; Abigail Norris Turner Journal: Sex Transm Dis Date: 2020-03 Impact factor: 3.868