Herpes Simplex Virus Type 2 Seroprevalence and Ultrasound-diagnosed Uterine Fibroids in a Large Population of Young African-American Women

Kristen R. Moore; Jennifer S. Smith; Stephen R. Cole; Victor J. Schoenbach; Katherine Schlusser; Charlotte A. Gaydos; Donna D. Baird*


Am J Epidemiol. 2016;183(11):961-968. 

In This Article


The median age of our cohort at enrollment was 29 years, and the median age at menarche was 12 years. The majority of participants were parous, and more than 40% had used DMPA. Forty-seven percent (n = 869) of the participants were seropositive for HSV-2. HSV-2 seropositive women tended to be older, to be less educated, to be heavier drinkers, to be parous, to be more likely to have ever used DMPA, to have had more sexual partners before age 20 years, and to have been younger at first sex compared with those who were seronegative for HSV-2 (Table 1).

Twenty-two percent of women had fibroids discovered at ultrasound screening (Table 2. Of those with fibroids, the size of the largest fibroid was less than 2 cm for 61%; 63% had only 1 fibroid. Among 51% of participants with fibroids, the total fibroid volume was less than 2 cm3.

In primary analyses, the odds of fibroids were similar for those who were HSV-2-seropositive and those who were HSV-2-seronegative, in both age- and multivariable-adjusted models (multivariable-adjusted odds ratio = 0.94, 95% confidence interval: 0.73, 1.20) (Table 2). In secondary analyses, we evaluated size of the largest fibroid, number of fibroids, and total fibroid volume as the outcomes (Figure 1. There was no significant association between HSV-2 exposure and fibroid size, number, or total volume.

Figure 1.

Size of largest fibroid, number of fibroids, and total fibroid volume in relation to herpes simplex virus type 2 (HSV-2) serostatus among young African-American women with fibroids (n = 365), Study of Environment, Lifestyle, and Fibroids, Detroit, Michigan, 2010–2012. The participants were aged 23–34 years. Odds ratios (aORs) and 95% confidence intervals (CIs) were adjusted for age, age at menarche, depot medroxyprogesterone acetate use, and parity.

We also examined the relationship between symptomatic herpes and fibroid presence based on a combination of self-reported genital herpes and serology data (Table 3). Only 16% of women who were seropositive for HSV-2 reported having had a genital herpes diagnosis (sensitivity for self-reported HSV-2 exposure). However, 98% of those who were seronegative reported no diagnosis of genital herpes (specificity). Those who were seropositive and reported an HSV-2 diagnosis (our measure of symptomatic herpes) did not have higher odds of fibroids. Furthermore, the lack of an association between HSV-2 and fibroids remained consistent across the sensitivity analyses performed (Table 4).