Herpes in pregnancy may raise HIV risk for baby

By Anne Harding

NEW YORK (Reuters Health) – HIV-positive women diagnosed
with genital herpes during pregnancy appear to be quite likely
to pass HIV to their infants, according to a study conducted in
New York City.

Other studies are needed to confirm the relationship, lead
investigator Dr. Katherine T. Chen of Columbia University told
Reuters Health.

At present, she noted, HIV-positive women who contract
herpes during pregnancy are treated for herpes infection and
given medications beginning at approximately 36 weeks to
prevent the transmission of herpes to the infant — the same
way such infections are treated in pregnant women without HIV.

The big question that remains unanswered, Chen explained,
is whether HIV-positive women with any prior or current history
of herpes infection should receive anti-herpes drugs throughout
pregnancy in order to prevent transmission not only of herpes
but also HIV.

As reported in the journal Obstetrics and Gynecology, Chen
and her team evaluated 402 HIV-positive pregnant women, 5
percent of whom had a diagnosis of herpes during pregnancy. Six
of the 21 women with herpes delivered HIV-infected infants.

After accounting for other risk factors for perinatal HIV
transmission, the researchers found that herpes infection
raised the risk of the baby becoming infected with HIV by
nearly fivefold.

One of the study’s strengths is that herpes diagnosis was
clinically confirmed; its weaknesses include the lack of
information on HIV levels for the pregnant women, Chen told
Reuters Health. She and her colleagues are currently conducting
a trial in which they are analyzing viral levels for both HIV
and herpes in the genital fluid of HIV-positive pregnant women.

SOURCE: Obstetrics and Gynecology, December 2005.