It is well known that genital herpes increases the risk of transmission of HIV during anal or vaginal intercourse. In the current study, published in the December 2005 issue of Obstetrics and Gynecology, researchers assessed the risk of perinatal HIV transmission in HIV-infected women clinically diagnosed with genital herpes simplex virus (HSV) infection during pregnancy.

This retrospective analysis included 402 HIV-infected pregnant women who enrolled from 1994–1999 in a multicenter prospective cohort study in New York City, who delivered a live-born infant with known HIV infection status, and who had information on diagnosis of genital HSV infection during pregnancy.

Study participants were determined to have genital HSV infection during pregnancy by documentation of clinical diagnosis.

Results

• Forty-six (11.4%) of the study participants delivered HIV-infected infants.
• Twenty-one (5.2%) had clinical diagnosis of genital HSV infection in pregnancy.
• Six (28.6%) of the 21 HIV-infected women with a clinical diagnosis of genital HSV infection delivered an HIV-infected infant.
• In univariate analyses, HIV-infected pregnant women with clinical diagnosis of genital HSV infection during pregnancy had a significantly increased risk of perinatal HIV transmission.
• When other factors associated with perinatal HIV transmission were included in a logistic regression model (lack of zidovudine [Retrovir] therapy during pregnancy or delivery, prolonged rupture of membranes, and preterm delivery), clinical diagnosis of genital HSV infection during pregnancy remained a significant independent predictor of perinatal HIV transmission (P = .02).

Based on these results, the study authors conclude, “Clinical diagnosis of genital HSV infection during pregnancy in HIV-infected women may be a risk factor for perinatal HIV transmission.”

“If future studies confirm this association, therapy to suppress genital HSV reactivation during pregnancy may be a strategy to reduce perinatal HIV transmission.”

From the Department of Obstetrics and Gynecology, Departments of Epidemiology, Columbia University, Sergievsky Center and Harlem Hospital Center, Columbia University, New York, New York; Fundació Barcelona SIDA 2002, Barcelona, Spain; Medical and Health Research Association, New York, New York; and ⁷Division of HIV/AIDS Prevention, National Center for HIV/STD/TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.

01/13/05

Reference
K T Chen and others. Genital Herpes Simplex Virus Infection and Perinatal Transmission of Human Immunodeficiency Virus. Obstetrics and Gynecology 106: 1341-1348. December 2005.

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