A multicenter study of bacterial vaginosis in women with or at risk for human immunodeficiency virus infection.

Abstract

BACKGROUND:

Bacterial vaginosis is a common gynecologic infection that has been associated with a variety of gynecologic and obstetric complications, including pelvic inflammatory disease, postabortal infection and premature delivery. Recent studies suggest that bacterial vaginosis may increase a woman's risk for human immunodeficiency virus (HIV). We undertook this study to assess whether the prevalence and characteristics of bacterial vaginosis differed according to HIV status in high-risk US women.

METHODS:

Prevalence of bacterial vaginosis was assessed by Gram's stain and clinical criteria for 854 HIV-infected and 434 HIV-uninfected women enrolled in the HIV Epidemiology Research (HER) Study. Multiple logistic regression techniques were used to determine whether HIV infection independently predicted bacterial vaginosis.

RESULTS:

Almost half (46%) the women had bacterial vaginosis by Gram's stain. The prevalence of bacterial vaginosis was 47% in the HIV-positive women compared with 44% in the HIV-negative women; this difference was not statistically significant (p = 0.36). After adjustment for other covariates, HIV-positive women were more likely than HIV-negative women to have bacterial vaginosis (odds ratio (OR) 1.31; 95% confidence interval (CI) 1.01-1.70) by Gram's stain but not by clinical criteria (OR 1.16; CI 0.87-1.55). Among HIV-positive women, use of antiretroviral drugs was associated with a lower prevalence of bacterial vaginosis (adjusted OR 0.54; Cl 0.38-0.77).

CONCLUSIONS:

In this cross-sectional analysis of high-risk US women, HIV infection was positively correlated with bacterial vaginosis diagnosed by Gram's stain.

• Authors: D Warren, R S Klein, J Sobel, B Kieke Jr, W Brown, P Schuman, J Anderson, S Cu-Uvin, K Mayer, D J Jamieson, S Holmberg, A Duerr, HIV Epidemiology Research Study Group
• Journal: Infectious diseases in obstetrics and gynecology (Infect Dis Obstet Gynecol) Vol. 9 Issue 3 Pg. 133-41 ( 2001) ISSN: 1064-7449 [Print] Egypt
• PMID: 11516061 (Publication Type: Journal Article, Multicenter Study, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Gram's stain
• Phenazines
• Gentian Violet

Topics

• AIDS-Related Opportunistic Infections (epidemiology, microbiology)
• Adolescent
• Adult
• Cross-Sectional Studies
• Female
• Gentian Violet
• HIV Infections (complications, epidemiology)
• Humans
• Middle Aged
• Odds Ratio
• Phenazines
• Prevalence
• Risk Factors
• Vaginosis, Bacterial (complications, diagnosis, epidemiology)