A study1 into the link between herpes (herpes simplex 1 and herpes simplex 2) and bacterial vaginosis (BV) has been conducted. The study relates to the incidence of HIV infection, since previously it has been put forward that HIV and BV go hand in hand, due to BV microbes creating an unfriendly environment for good bacteria, thus leaving the vagina exposed to invaders.
Take-homes from the study:
HSV-2 (genital herpes) and BV appear to have a link. This link may be the same as the link for other sexually transmitted infections like HIV, with the increased risk likely due to a lack of vaginal protections from healthy microbes.
The women researched are sex workers in Burkina Faso, a West African country. Women of African descent are known to have more BV than other women, due to normal variations in vaginal microflora. This means the population of women studied are already in a position to more often develop BV, plus extra sexual activity with multiple partners putting them at increased risk of contracting sexually transmitted infections such as herpes.
What this means is that we’re dealing with an extra susceptible group of women. The study followed 273 women, with three-monthly visits to diagnose genital infections and to report on sexual behaviours.
What the study found
- Women who had three or more sexual partners in the preceding week had more BV
- Women who were on hormonal contraception saw a protective effect
- HSV-2 was associated with BV in this population
- BV incidence was not linked to HIV infection
- HSV-2 status was independent of HIV status as it related to incidence of BV
- BV could facilitate HSV-2 acquisition
What’s the theory behind the link?
The researchers explained that it’s possible that intermittent HSV-2 genital shedding could disrupt vaginal flora or be linked to hormonal changes (i.e. menstrual blood), which can both trigger episodes of BV. BV has previously been strongly associated with HSV-2 shedding episodes. The consistent protection of hormonal contraception seems to be confirmed, though this could be because BV microbes favour an alkaline environment, provided by menstrual blood.
- Nagot N, Ouedraogo A, Defer M, Vallo R, Mayaud P, Van de Perre P. Association between bacterial vaginosis and Herpes simplex virus type‐2 infection: implications for HIV acquisition studies. Sexually Transmitted Infections. 2007;83(5):365-368. doi:10.1136/sti.2007.024794 ↩