Am J Epidemiol 2002; 156:687-692.
Copyright © 2002 by the
Johns Hopkins Bloomberg School of Public Health
ORIGINAL CONTRIBUTIONS |
Herpes Simplex Virus and Risk of Cervical Cancer: A Longitudinal, Nested Case-Control Study in the Nordic Countries
1 School of Public Health, University of Tampere, Tampere, Finland.
2 National Public Health Institute, Oulu, Finland.
3 Institute of Clinical Biochemistry, University of Oslo, Oslo, Norway.
4 Department of Microbiology, University of Oulu, Finland.
5 Department of Nutrition Research, University of Umeå, Umeå, Sweden.
6 The Cancer Registry of Norway, Oslo, Norway.
7 Clinical Trial Service Unit, University of Oxford, Oxford, United Kingdom.
8 Department of Clinical Microbiology, University of Lund, Malmö, Sweden.
9 Finnish Cancer Registry, Helsinki, Finland.
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.
cervix neoplasms; herpes simplex; longitudinal studies; meta-analysis; retrospective studies
Abbreviations: Abbreviations: CI, confidence interval; ELISA, enzyme-linked immunosorbent assay; HPV, human papillomavirus; HSV-2, herpes simplex virus type 2; RR, relative risk.
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