HSV-2感染女性的宫颈无症状排泌HSV相关因素研究

Factors associated with HSV shedding from cervix of HSV-2 seropositive asymptomatic females

目的应用FQ-PCR方法检测宫颈HSV2-DNA,探讨女性HSV-2感染宫颈无症状排泌病毒与病史、宫颈情况、取材时间的相关性,从而为减少病毒传播提供指导。方法用型特异性抗体筛选HSVgG2-IgG阳性女性34例,其中无GH(Genital herpes,GH)病史女性18例,有GH病史者16例,连续2个月每月在排卵期和月经前无症状时行宫颈分泌物取材,使用FQ-PCR方法检测宫颈HSV2-DNA。结果有GH病史的16名患者中11名检测到宫颈拭子HSV2-DNA,无GH病史的18名患者中8名检测到宫颈HSV2-DNA。经LOGISTIC分析发现无症状时有病史患者经宫颈排泌HSV-2是无病史的9倍。患者无皮疹发作时,无论宫颈是否异常,HSV2-DNA阳性率差异无统计学意义(χ2=1.55,P>0.05)。FQ-PCR方法检测宫颈HSV2-DNA阳性率在排卵期为23.5%,月经前为25%。结论HSVgG2-IgG阳性的患者,即使无GH症状,仍可通过宫颈排泌HSV-2,有病史者宫颈排泌HSV-2的可能性大于无病史者。HSVgG2-IgG阳性女性在排卵期和月经前期宫颈HSV-2 DNA阳性率高于文献报道月经周期的平均排泌率。

Objective To investgate the related factors of HSV shedding from cervix of HSVgG：-IgG seropositives but asymptomatic females. Methods Specific kits was used for screening 34 HSVgG2-IgG seropesitive females without clinical manifestations by detection of cervical secretion in the ovulation period and premenstrum respectively for a consecutive 2 months. Results HSV-2 DNA was detected from 11 of 16 females with history of genital herpes （GH） and 8 of 18 females without GH history. LOGISTIC regression analysis showed that the risk of shedding HSV-2 in cervix by HSVgG2-IgG seropositive females with history of genital herpes was 9 times higher than the females without GH history. The HSV shedding rate in the period of the ovulation period was 23.5% and25% in the premenstrum. Conlusions For HSVgC2-IgG seropositive females, even those never had GH history, they might shed HSV-2 in cervix..