Prospective studies of the association of genital herpes simplex infection and cervical anaplasia.

The various problems associated with prospective epi demiolÃ3gica! studies, aimed at evaluating the risk of cer vical 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 fol low-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 anti bodies could not be detected serologically. The rate of cer vical 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 pri mary one. These findings are discussed below within an herpes simplex virus-cell interaction scheme which takes into account the important consideration of the known re currences of herpetic cervicitis. Our results should be viewed at present as only preliminary, since further epidemiological variables, currently being obtained, may in fluence 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 cer vical cancer.