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ASSOCIATIONS BETWEEN HERPES SIMPLEX VIRUS TYPES 1 AND 2 (HSV-1 AND HSV-2), CYTOMEGALOVIRUS (CMV), EPSTEIN BARR VIRUS (EBV), HUMAN PAPILLOMA VIRUS (HPV), CHLAMYDIA TRACHOMATIS, NEISSERIA GONORRHOEAE INFECTIONS AND PREECLAMPSIA

Rustveld, Luis Orlando (2005) ASSOCIATIONS BETWEEN HERPES SIMPLEX VIRUS TYPES 1 AND 2 (HSV-1 AND HSV-2), CYTOMEGALOVIRUS (CMV), EPSTEIN BARR VIRUS (EBV), HUMAN PAPILLOMA VIRUS (HPV), CHLAMYDIA TRACHOMATIS, NEISSERIA GONORRHOEAE INFECTIONS AND PREECLAMPSIA. Doctoral Dissertation, University of Pittsburgh.

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    Abstract

    BACKGROUND Atherosclerosis, endothelial dysfunction and inflammation are thought to be key pathophysiologic processes in preeclampsia. The basic thesis of this dissertation is that maternal infections may trigger upregulation of proinflammatory cytokines in women with preeclampsia resulting in vascular injury.OBJECTIVES We evaluated the evidence for a potential infectious disease etiology for preeclampsia in three papers. METHODS For the first paper, we conducted a 1:3 matched case control study. In this study we measured immunoglobulin G (IgG) antibodies to HSV-1, HSV-2, CMV, and EBV in serum samples obtained from 50 cases with preeclampsia and 150 normotensive controls, matched on age, parity and race. For the second paper, we conducted a comprehensive review of published studies that explored the association between both bacterial and viral infections, and examined the strength of this association. For the third paper, we investigated the association between self-reported Genital Warts (HPV), Genital Herpes (HSV-2), Chlamydia (C. trachomatis), Gonorrhea (N. gonorrhoeae) infections, sociodemographic, and behavioral risk factors and the risk of preeclampsia in a representative national sample of 10,847 reproductive age women.RESULTS We found that seroconversion for HSV 1 /2 or CMV was associated with a five-fold increased risk for developing preeclampsia (OR 5.4, 95% CI 1.0-29.0) after adjusting for education, income, smoking, years of cohabitation, medical insurance, and type of birth control. Pooling of relevant epidemiologic data, also revealed a two-fold increased risk of preeclampsia associated with bacterial and viral infections (OR 2.1, 95% CI 1.8-2.6). Additionally, population-based results suggest that Genital Warts, Genital Herpes, and C. trachomatis significantly increased the risk of preeclampsia (OR 3.0, 95% CI 1.0-8.8; OR 7.4, 95% CI 1.4-47.4; OR 5.2, 95% CI 1.3-20.2, respectively), after adjusting for socio-demographic, behavioral, and infection-related risk factors. PUBLIC HEALTH RELEVANCE Given the widespread prevalence of these infections, and the potential to prevent infection, our findings have important public health implications in the context of potential preventive strategies and identification of high-risk individuals.


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    Item Type: University of Pittsburgh ETD
    Creators/Authors:
    CreatorsEmailPitt UsernameORCID
    Rustveld, Luis OrlandoLorst1@pitt.eduLorst1@pitt.edu
    ETD Committee:
    ETD Committee RoleCommittee MemberEmailPitt UsernameORCID
    Committee ChairLaPorte, Ronald E.ronlaporte@aol.comronlaporte@aol.com
    Committee MemberSharma, Ravi K.rks1946@pitt.edurks1946@pitt.edu
    Committee MemberEvans, Rhobert W.evansr@edc.pitt.eduevansr@edc.pitt.edu
    Committee MemberRycheck, Russel R.rycheckr@edc.pitt.edurycheckr@edc.pitt.edu
    Committee MemberKelsey, Sheryl F.kelsey@edc.pitt.edukelsey@edc.pitt.edu
    Title: ASSOCIATIONS BETWEEN HERPES SIMPLEX VIRUS TYPES 1 AND 2 (HSV-1 AND HSV-2), CYTOMEGALOVIRUS (CMV), EPSTEIN BARR VIRUS (EBV), HUMAN PAPILLOMA VIRUS (HPV), CHLAMYDIA TRACHOMATIS, NEISSERIA GONORRHOEAE INFECTIONS AND PREECLAMPSIA
    Status: Unpublished
    Abstract:

    BACKGROUND Atherosclerosis, endothelial dysfunction and inflammation are thought to be key pathophysiologic processes in preeclampsia. The basic thesis of this dissertation is that maternal infections may trigger upregulation of proinflammatory cytokines in women with preeclampsia resulting in vascular injury.OBJECTIVES We evaluated the evidence for a potential infectious disease etiology for preeclampsia in three papers. METHODS For the first paper, we conducted a 1:3 matched case control study. In this study we measured immunoglobulin G (IgG) antibodies to HSV-1, HSV-2, CMV, and EBV in serum samples obtained from 50 cases with preeclampsia and 150 normotensive controls, matched on age, parity and race. For the second paper, we conducted a comprehensive review of published studies that explored the association between both bacterial and viral infections, and examined the strength of this association. For the third paper, we investigated the association between self-reported Genital Warts (HPV), Genital Herpes (HSV-2), Chlamydia (C. trachomatis), Gonorrhea (N. gonorrhoeae) infections, sociodemographic, and behavioral risk factors and the risk of preeclampsia in a representative national sample of 10,847 reproductive age women.RESULTS We found that seroconversion for HSV 1 /2 or CMV was associated with a five-fold increased risk for developing preeclampsia (OR 5.4, 95% CI 1.0-29.0) after adjusting for education, income, smoking, years of cohabitation, medical insurance, and type of birth control. Pooling of relevant epidemiologic data, also revealed a two-fold increased risk of preeclampsia associated with bacterial and viral infections (OR 2.1, 95% CI 1.8-2.6). Additionally, population-based results suggest that Genital Warts, Genital Herpes, and C. trachomatis significantly increased the risk of preeclampsia (OR 3.0, 95% CI 1.0-8.8; OR 7.4, 95% CI 1.4-47.4; OR 5.2, 95% CI 1.3-20.2, respectively), after adjusting for socio-demographic, behavioral, and infection-related risk factors. PUBLIC HEALTH RELEVANCE Given the widespread prevalence of these infections, and the potential to prevent infection, our findings have important public health implications in the context of potential preventive strategies and identification of high-risk individuals.

    Date: 09 June 2005
    Date Type: Completion
    Defense Date: 08 December 2004
    Approval Date: 09 June 2005
    Submission Date: 17 March 2005
    Access Restriction: No restriction; The work is available for access worldwide immediately.
    Patent pending: No
    Institution: University of Pittsburgh
    Thesis Type: Doctoral Dissertation
    Refereed: Yes
    Degree: PhD - Doctor of Philosophy
    URN: etd-03172005-152935
    Uncontrolled Keywords: Chlamydia trachomatis; Genital Warts; Herpes Simplex; Neisseria gonorrhoeae; Preeclampsia
    Schools and Programs: Graduate School of Public Health > Epidemiology
    Date Deposited: 10 Nov 2011 14:32
    Last Modified: 02 Mar 2012 11:59
    Other ID: http://etd.library.pitt.edu/ETD/available/etd-03172005-152935/, etd-03172005-152935

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