Herpes in pregnancy may raise HIV risk for baby

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, said lead investigator Dr. Katherine T. Chen of Columbia University.

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.