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Prospective Studies of the Association of Genital Herpes Simplex Infection and Cervical Anaplasia¹

Departments of Pediatrics and Preventive Medicine [A. J. N.], Pathology [Z. M. N.], and Gynecology and Obstetrics [W. E. J., E. F., R. J.], Woodruff Medical Center, Emory University School of Medicine, Atlanta, Georgia 30322

The various problems associated with prospective epidemiological studies, aimed at evaluating the risk of cervical anaplasia in women detected earlier with genital herpetic or herpes simplex virus type 2 (HSV-2) infection are identified. Preliminary results are included of ongoing follow-up studies in 871 women (herpes group) detected serologically, cytologically, or virologically with such infections and in 562 women (control group) in whom HSV-2 antibodies could not be detected serologically. The rate of cervical dysplasia was found to be greater than two-fold and that of in situ carcinoma, 8-fold higher in the herpes group than the rate observed in the control group. There was also a greater than two-fold higher rate of in situ carcinoma in women who were pregnant at the time of diagnosis of their genital herpetic infection, as compared to women in whom the genital herpetic infection was detected during a nonpregnant period. The rate of cervical anaplasia in women identified with a primary HSV-2 infection was less than that found when the infection was not identified as a primary one. These findings are discussed below within an herpes simplex virus-cell interaction scheme which takes into account the important consideration of the known recurrences of herpetic cervicitis. Our results should be viewed at present as only preliminary, since further epidemiological variables, currently being obtained, may influence final interpretation as to causality of the herpesvirus in cervical carcinogenesis. Nevertheless, our results do point to women identified with a genital herpetic or HSV-2 infection as a special population that requires more careful Papanicolaou cervicovaginal screening for cervical cancer.

¹ Presented at the American Cancer Society Conference on Herpesvirus and Cervical Cancer, December 8 to 10, 1972, Key Biscayne, Fla. Supported by grants from the American Cancer Society and the National Cancer Institute, USPHS.

² Presented by.

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