Determinants of Incident Vulvovaginal Candidiasis inHuman Immunodeficiency Virus-Positive Women

[摘要] Objective:Mucosal infections including vulvovaginal candidiasis are a common problem for womenwith human immunodeficiency virus (HIV) infection. Our objective was to determine which factorspredict the development of symptomatic disease among HIV-infected women.Materials and Methods:In a prospective study from 1991 to 1995, 205 HIV-positive women wereevaluated every 6 months for occurrences of vulvovaginal candidiasis. Included in the study wereall initially asymptomatic women, whether they were fungal-culture-positive or -negative at baseline.Excluded from the study were all women with symptomatic vulvovaginal candidiasis at theinitial visit, those who developed trichomonas vaginitis at any visit, and those who used any antifungalagents.Results:The risk of the development of vulvovaginal candidiasis did not differ between womenwho were asymptomatically colonized at baseline and those who were fungal-culture-negative.However, the risk of developing vulvovaginal candidiasis was increased 6.8 times for women withCD4 counts less than 200 cells/mm3at baseline.Conclusions:Fungal culture is not predictive of the development of symptomatic vulvovaginalcandidiasis. Women infected with HIV who have CD4 counts below 200 cells/mm3should bemonitored more carefully for vulvovaginal candidiasis. Infect. Dis. Obstet. Gynecol. 8:176–180,2000.

[学科分类] 妇产科学