A Multicenter Study of Bacterial Vaginosis in Women With orat Risk for Human Immunodeficiency Virus Infection

[摘要] Background:Bacterial vaginosis is a common gynecologic infection that has been associated with a variety ofgynecologic and obstetric complications, including pelvic inflammatory disease, postabortal infection and prematuredelivery. Recent studies suggest that bacterial vaginosis may increase a woman’s risk for human immunodeficiencyvirus (HIV). We undertook this study to assess whether the prevalence and characteristics of bacterialvaginosis 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-infectedand 434 HIV-uninfected women enrolled in the HIV Epidemiology Research (HER) Study.Multiple logistic regressiontechniques 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 bacterialvaginosis was 47% in the HIV-positive women compared with 44% in the HIV-negativewomen; this difference wasnot statistically significant (p = 0.36). After adjustment for other covariates, HIV-positive women were more likelythan 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 ofantiretroviral drugs was associated with a lower prevalence of bacterial vaginosis (adjusted OR 0.54; Cl0.38 -0.77).Conclusions:In this cross-sectional analysis of high-risk US women, HIV infection was positively correlated withbacterial vaginosis diagnosed by Gram’s stain.

[学科分类] 妇产科学