Display Settings:

Format

Send to:

Choose Destination
See comment in PubMed Commons below
J Obstet Gynaecol Res. 2012 Jan;38(1):77-83. doi: 10.1111/j.1447-0756.2011.01697.x. Epub 2011 Dec 5.

Recalcitrance of bacterial vaginosis among herpes-simplex-virus-type-2-seropositive women.

Author information

  • 1Departments of Obstetrics and Gynecology and Reproductive Sciences Pediatrics Medicine Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

Abstract

AIM:

The multifactorial etiology of bacterial vaginosis (BV) impedes development of effective treatment and prevention strategies. Herein, we evaluated the effects of herpes simplex virus type 2 (HSV-2), a suspected BV risk factor, on vaginal flora composition.

MATERIALS AND METHODS:

  Correlations between HSV-2 infection and BV were prospectively explored among 12 HSV-2-seropositive women with asymptomatic BV who were asked to collect daily vaginal swab specimens for Gram stain analysis of vaginal flora and determination of HSV-2 shedding frequencies during the 1month before and after metronidazole therapy.

RESULTS:

Unlike prior longitudinal studies that reported rapid fluctuations in vaginal flora composition and frequent episodes of spontaneously resolving BV, we found that 99.4% (310/312) of vaginal smears collected before initiation of metronidazole were consistent with a diagnosis of BV. Effectiveness of metronidazole therapy was also much lower than previously reported in studies not restricting enrollment to HSV-2-seropositive women; we observed a BV recurrence rate of 89% in the first month after completion of therapy while the median time to this recurrence occurred only 14days after treatment.

CONCLUSIONS:

Our study demonstrates BV recalcitrance among HSV-2-infected women and provides additional evidence for a linkage between this chronic viral infection and abnormal vaginal flora. Additional work will be needed to define mechanisms responsible for this correlation and to determine if vaginal flora health of HSV-2-infected women is improved by medications that suppress HSV-2 shedding.

© 2011 The Authors. Journal of Obstetrics and Gynaecology Research © 2011 Japan Society of Obstetrics and Gynecology.

PMID:
22136755
[PubMed - indexed for MEDLINE]
PMCID:
PMC3253171
Free PMC Article

Images from this publication.See all images (3)Free text

Figure 1
Figure 2
Figure 3
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Icon for Blackwell Publishing Icon for PubMed Central
    Loading ...
    Write to the Help Desk