4.6 Article

Herpes Simplex Virus Type 2 Seroprevalence and Incidence and Growth of Ultrasound-Diagnosed Uterine Fibroids in a Large Population of Young African-American Women

Journal

AMERICAN JOURNAL OF EPIDEMIOLOGY
Volume 190, Issue 10, Pages 2158-2162

Publisher

OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kwab160

Keywords

herpes simplex virus type 2; incidence; seroprevalence; tumor growth; uterine fibroids

Funding

  1. Intramural Research Program of the National Institutes of Health, National Institute of Environmental Health Sciences [ZIA ES040913-25]
  2. American Recovery and Reinvestment Act funds designated for National Institutes of Health research

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In a study of African-American women in Detroit, Michigan, there was found to be no association between HSV-2 infection and uterine fibroids. Longitudinal measures showed that HSV-2 infection did not increase the risk of fibroid-related health problems in women.
Reproductive tract infections have long been hypothesized to be risk factors for development of uterine fibroids, but few studies have investigated the issue. In our 2016 cross-sectional analysis from the Study of Environment, Lifestyle and Fibroids (2010-2018), a large Detroit, Michigan, community-based cohort study of 23- to 35-year-old African-American women with ultrasound fibroid screening, we found no association between a very prevalent reproductive tract infection, herpes simplex virus type 2 (HSV-2), and fibroids. With prospective data from the cohort (ultrasounds performed every 20 months over 5 years), we examined HSV-2's associations with fibroid incidence (among 1,208 women who were fibroid-free at baseline) and growth (among women with fibroids at baseline or diagnosed during the study). Using Cox proportional hazards models, we computed adjusted hazard ratios and 95% confidence intervals for fibroid incidence comparing HSV-2-seropositive women with HSV-2-seronegative women. The influence of HSV-2 infection on growth was assessed on the basis of the difference in fibroid size between successive ultrasounds (1,323 growth measures) using a linear mixed model, estimating the percent difference in growth scaled to 18 months. HSV-2 seropositivity was not associated with fibroid incidence (adjusted hazard ratio = 0.88, 95% confidence interval: 0.69, 1.12) or growth (estimated growth difference = 3.1%, 95% confidence interval: -5.8, 13.0). Women can be reassured that HSV-2 infection is unlikely to increase their risk of fibroid-related health problems, given these longitudinal measures.

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