A delicate balance: Risk factors for acquisition of bacterial vaginosis include sexual activity, absence of hydrogen peroxide-producing lactobacilli, black race, and positive herpes simplex virus type 2 serology
A delicate balance: Risk factors for acquisition of bacterial vaginosis include sexual activity, absence of hydrogen peroxide-producing lactobacilli, black race, and positive herpes simplex virus type 2 serology
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DOI：
10.1097/olq.0b013e318156a5d0
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发表时间：
2008-01-01
影响因子：
3.1
通讯作者：
Krohn, Marijane A.
中科院分区：
文献类型：
--
作者：
Cherpes, Thomas L.;Hillier, Sharon L.;Krohn, Marijane A.
背景：细菌性阴道病(BV)的病因尚不清楚，但更好地定义与其感染相关的危险因素将有助于我们对这一复杂疾病的了解。方法：对年轻的性行为活跃的女性进行纵向队列研究，以确定与BV感染相关的变量。773名登记时没有BV的妇女每隔4个月进行一次为期一年的跟踪调查。每次就诊时收集人口学和行为学资料，阴道涂片革兰氏染色诊断BV，血清样本检测单纯疱疹病毒I型(HSV-1)和单纯疱疹病毒2型(HSV-2)特异性抗体。结果：BV感染的总发生率为36例/100妇女年(619妇女年中223例BV感染)。BV感染与黑人种族、吸烟、阴道性交、阴道性交前接受肛交、与未割包皮的男性伴侣发生性关系、阴道内没有产生过氧化氢的乳酸菌、以及在BV感染前就诊时检测到HSV-2血清抗体等因素独立相关。纵向分析表明，HSV-2血清抗体与产H_2O_2乳酸菌的丢失独立相关。结论：我们的研究结果表明，多个和不同的危险因素可能导致BV感染。它们还说明了为什么更全面地了解BV的发病机制和制定有效的BV预防策略是难以捉摸的。还需要进一步的工作来确定HSV-2感染对阴道菌群组成和BV感染的具体影响。
Background: The etiology of bacterial vaginosis (BV) is poorly understood, but better definition of the risk factors associated with its acquisition should improve our understanding of this complex disease entity.Methods: A longitudinal cohort study of young sexually active women was conducted to identify variables associated with BV acquisition. Seven hundred seventy-three women without BV at enrollment were followed at 4-month intervals for 1 year. At each visit, demographic and behavioral interview data, a vaginal smear for the Gram stain diagnosis of BV, and a serum sample for detection of herpes simplex virus type I (HSV-1) and HSV-2 type-specific antibodies were collected.Results: The overall incidence of BV acquisition was 36 cases/100 woman-years (223 acquisitions of BV during 619 woman-years of follow-up). Acquisition of BV was independently associated with black race, cigarette smoking, vaginal intercourse, receptive anal sex before vaginal intercourse, sex with an uncircumcised male partner, lack of vaginal H2O2-producing lactobacilli, and the detection of HSV-2 serum antibodies at the visit before BV acquisition. Longitudinal analyses revealed that HSV-2 serum antibodies were independently associated with loss of H2O2-producing lactobacilli.Conclusions: Our findings suggest that multiple and diverse risk factors can contribute to BV acquisition. They also illustrate why a more complete understanding of BV pathogenesis and the formulation of effective BV prevention strategies have been elusive. Further work will be needed to determine the specific effects of HSV-2 infection on vaginal flora composition and the acquisition of BV.