Journal Article

Herpes Simplex Virus and Risk of Cervical Cancer: A Longitudinal, Nested Case-Control Study in the Nordic Countries

Matti Lehtinen, Pentti Koskela, Egil Jellum, Aini Bloigu, Tarja Anttila, Göran Hallmans, Tiina Luukkaala, Steinar Thoresen, Linda Youngman, Joakim Dillner and Matti Hakama

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 156, issue 8, pages 687-692
Published in print October 2002 | ISSN: 0002-9262
Published online October 2002 | e-ISSN: 1476-6256 | DOI:
Herpes Simplex Virus and Risk of Cervical Cancer: A Longitudinal, Nested Case-Control Study in the Nordic Countries

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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.

Keywords: cervix neoplasms; herpes simplex; longitudinal studies; meta-analysis; retrospective studies; Abbreviations: CI, confidence interval; ELISA, enzyme-linked immunosorbent assay; HPV, human papillomavirus; HSV-2, herpes simplex virus type 2; RR, relative risk.

Journal Article.  4020 words.  Illustrated.

Subjects: Public Health and Epidemiology

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