Cervical shedding of herpes simplex virus in human immunodeficiency virus-infected women: Effects of hormonal contraception, pregnancy, and vitamin Adeficiency

Genital shedding of herpes simplex virus (HSV) results in frequent transmis sion of infection to sexual partners and neonates, In a cross-sectional stu dy, cervical shedding of HSV DNA was detected in 43 (17%) cervical swab sam ples from 273 women seropositive for HSV-1, HSV-2, and human immunodeficien cy virus type 1 (HIV-1), Cervical shedding of HSV was significantly associa ted with oral contraception (adjusted odds ratio [aOR], 4.5; 95% confidence interval [CI], 1.7-12.2), use of depo-medroxyprogesterone acetate (aOR, 3. 2; 95% CI, 1.3-7.7), and pregnancy (aOR, 7.9; 95% CI, 2.0-31.7). In the sub group of women who were not pregnant and not using hormonal contraception ( n = 178), serum vitamin A was highly predictive of cervical HSV shedding: c oncentrations indicating severe deficiency, moderate deficiency, low-normal , and high-normal status were associated with 29%, 18%, 8%, and 2% prevalen ces of cervical HSV shedding, respectively (linear trend, P = .0002), Sever al factors appear to influence HSV reactivation in HIV-1 seropositive women .