Relationship between maternal herpes simplex virus-2 (HSV-2) and HIV vertical transmission
| Author | Time of test | OR (95% CI) | p Value | aOR (95% CI) | p Value | Variables adjusted for |
| HSV-2 seropositivity and MTCT | ||||||
| Aebi-Popp et al16 | Before conception (6%) During pregnancy (87%) After delivery (7%) | 0.8 (0.41 to 1.6) | 0.553 | 1.43 (0.54 to 3.77) | 0.474 | ARV use, mode of delivery, delivery at <37 weeks, injection drug use |
| Bollen et al17* | 38 weeks gestation | 2.7 (1.1 to 6.6) | 0.03 | 2.6 (1.0 to 6.7) | 0.05 | ZDV use, plasma HIV VL at delivery, CD4 count at 36 weeks, cervicovaginal HIV VL at 38 weeks |
| Chen et al13 | During pregnancy or 8 weeks postpartum | 0.4 (0.1 to 1.2) | 0.1 | ND | ND | – |
| Cowan et al14 | At delivery | 1.49 (1.10 to 2.02) | 0.01 | 1.50 (1.09 to 2.08) | 0.014 | Plasma HIV VL, CD4 count, haemoglobin, education, arm circumference, infant weight |
| Drake et al15* | 32 weeks gestation | 1.2 (0.4 to 3.8)† | 0.8 | ND | ND | – |
| Jamieson et al18 | Not reported | ‘Not significant’ | – | ND | ND | – |
| HSV-2 seropositivity and intrapartum MTCT | ||||||
| Bollen et al17 | 38 weeks gestation | 3.0 (0.7 to 13.4) | 0.15 | ND | ND | – |
| Drake et al15 | 32 weeks gestation | 3.8 (0.5 to 30.3) | 0.20 | ND | ND | – |
| HSV-2 shedding and MTCT | ||||||
| Bollen et al17 | 38 weeks gestation | 3.0 (1.2 to 7.4) | 0.02 | 2.3 (0.9 to 6.2) | 0.09 | ZDV use, plasma HIV VL at delivery, CD4 count at 36 weeks, cervicovaginal HIV VL at 38 weeks |
| Chen et al13 | 10–32 weeks gestation (average 16.4 weeks) | 0.4 (0.02 to 10.0) | 1.0 | ND | ND | – |
| Drake et al15* | At delivery | 1.7 (0.4 to 7.1) | 0.50 | ND | ND | – |
| HSV-2 shedding and intrapartum MTCT | ||||||
| Bollen et al17 | 38 weeks gestation | 1.3 (0.3 to 6.3) | 0.71 | ND | ND | – |
| Drake et al15 | At delivery | 1.9 (0.5 to 7.5) | 0.40 | ND | ND | – |
| HSV-2 culture and MTCT | ||||||
| Chen et al19 | During pregnancy | 0.70 (0.09 to 5.53)‡ | 0.7 | ND | ND | – |
| Hitti et al21 | Within 48 hours of delivery | 0 (0.05 to 21.76)‡ | 1.00 | ND | ND | – |
| Pitt et al22 | Not reported§ | 1.26 (0.62 to 2.57)‡ | 0.52 | ND | ND | – |
| Clinical diagnosis of herpes and MTCT | ||||||
| Chen et al19 | During pregnancy | 3.4 (1.3 to 9.3) | 0.02 | 4.8 (1.3 to 17.0) | 0.02 | ZDV use, ROM≥4 hours, delivery at <37 weeks |
| Van Dyke et al23 | During pregnancy | 1.94 (0.62 to 6.02)§ | 0.22 | ND | ND | – |
| Ever | 1.61 (0.57 to 4.51) | 0.28 | ND | ND | – | |
| Genital ulcer disease and MTCT | ||||||
| Drake et al15 | 32 weeks gestation | 7.4 (1.7 to 32.8) | 0.003 | 5.1 (1.1 to 24.1) | 0.04 | Plasma HIV VL at delivery |
*Intrapartum transmissions only.
†Calculated from data in report.
‡Relative risk reported.
§Method of HSV-2 ascertainment not reported but presumed to be culture based on year of study.
aOR, adjusted OR; ARV, antiretroviral; HSV-2, herpes simplex virus-2; MTCT, mother to-child transmission; ND, not done; ROM, rupture of membranes; VL, viral load; ZDV, zidovudine.