Herpes simplex virus and risk of cervical cancer: a longitudinal, nested case-control study in the nordic countries

Am J Epidemiol. 2002 Oct 15;156(8):687-92. doi: 10.1093/aje/kwf098.

Abstract

Human papillomaviruses (HPVs) play the major role in cervical carcinogenesis. The authors reevaluated the role of herpes simplex virus type 2 (HSV-2) in this multistage process by conducting a longitudinal, nested case-control study using 1974-1993 data and comparing the results with those from a meta-analysis of studies. A Nordic cohort of 550,000 women was followed up for an average of 5 years, after which 178 cervical carcinoma cases and 527 controls were identified. HSV-2; HPV-16, HPV-18, and HPV-33; and Chlamydia trachomatis antibodies were determined at baseline by HSV-2 glycoprotein gG-2 and HPV virus-like-particle enzyme immunoassays and by using the microimmunofluorescence method. The relative risk of cervical carcinoma was calculated by conditional logistic regression. Longitudinal studies on HSV-2 and cervical neoplasia were identified through MEDLINE (National Library of Medicine, Bethesda, Maryland), and weighted mean relative risks were calculated. Smoking (relative risk = 1.6, 95% confidence interval (CI): 1.1, 2.3) and HPV-16/HPV-18/HPV-33 (relative risk = 2.9, 95% CI: 1.9, 4.3) were both associated with cervical carcinoma. The smoking- and HPV-16/HPV-18/HPV-33-adjusted relative risks for HSV-2 were 1.0 (95% CI: 0.6, 1.7) and 0.7 (95% CI: 0.3, 1.6), respectively, for HPV seropositives. In the meta-analysis, the relative risk for HSV-2 was 0.9 (95% CI: 0.6, 1.3). In both sets of data, HSV-2 did not play a role in cervical carcinogenesis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Carcinoma / epidemiology
  • Carcinoma / etiology
  • Carcinoma / virology*
  • Case-Control Studies
  • Cell Transformation, Neoplastic
  • Female
  • Finland / epidemiology
  • Herpes Genitalis / complications*
  • Herpesvirus 2, Human / pathogenicity*
  • Humans
  • Longitudinal Studies
  • Middle Aged
  • Norway / epidemiology
  • Papillomaviridae / pathogenicity
  • Papillomavirus Infections / complications
  • Risk Factors
  • Smoking / adverse effects
  • Sweden / epidemiology
  • Tumor Virus Infections / complications
  • Uterine Cervical Neoplasms / epidemiology
  • Uterine Cervical Neoplasms / etiology
  • Uterine Cervical Neoplasms / virology*