Factors Associated With the Recurrence, Persistence, and Clearance of Asymptomatic Bacterial Vaginosis Among Young African American Women: A Repeated-Measures Latent Class Analysis.
Factors Associated With the Recurrence, Persistence, and Clearance of Asymptomatic Bacterial Vaginosis Among Young African American Women: A Repeated-Measures Latent Class Analysis.
复制标题
DOI：
10.1097/olq.0000000000001256
复制
发表时间：
2020-12
影响因子：
3.1
通讯作者：
Madhivanan P
中科院分区：
文献类型：
--
作者：
Coudray MS;Sheehan DM;Li T;Cook RL;Schwebke J;Madhivanan P
虽然文献已经探讨了复发性和持续性细菌性阴道病（BV）的危险因素，但BV的纵向发病率模式仍然难以捉摸。我们对一项甲硝唑治疗无症状细菌性脑膜炎的随机临床试验的纵向数据进行了二次分析。使用重复测量潜类分析（RMLCA）来确定BV病例发生的不同纵向模式。采用多项回归分析确定班级成员的预测因子。多变量模型包括年龄、最后一次BV治疗、冲洗频率、生育控制、性危险行为和治疗组分配。共有858名无细菌性阴道炎症状的非裔美国妇女被纳入分析。在12个月内，RMLCA鉴定出三种出现的BV模式：持续（55.9%），复发（30.5%）和清除（13.5%）。至少冲洗过一次的受试者与清除组相比，复发组的几率显著降低（调整后的优势比[adjOR]: 0.55； 95%可信区间[CI]: 0.18-0.63）。与清除类（adjOR: 0.38; 95% CI: 0.22-0.68）和复发类（adjOR: 0.43; 95% CI: 0.23-0.81）相比，与女性发生性关系的女性（WSW）属于持续性类的几率明显较低。与清除率组相比，被分配到治疗组的患者进入复发组的几率显著增加（adjOR: 1.92; 95% CI: 1.22-3.03）。年龄在0 ~ 21岁之间的女性更有可能属于复发组（adjOR: 1.88; 95% CI: 1.17-3.00），而不是清除率组。对细菌性阴道炎病例的评估揭示了细菌性阴道炎复发和持续存在的独特模式，这与冲洗、在治疗组以及与女性发生性行为显著相关。对无症状BV的年轻女性进行了一年的随访，我们确定了与BV复发、持续或清除相关的因素。
While risk factors of recurrent and persistent bacterial vaginosis (BV) have been explored in the literature, the longitudinal incidence patterns of BV remain elusive. We conducted a secondary analysis of longitudinal data from a randomized clinical trial of metronidazole treatment for asymptomatic BV. Repeated Measures Latent Class Analysis (RMLCA) was used to identify distinct longitudinal patterns of incident BV cases. Multinomial regression analysis was used to determine the predictors of class membership. The multivariable model included age, last BV treatment, douching frequency, birth control, sexual risk behavior and assignment to treatment arm. A total of 858 African American women, asymptomatic for BV were included in the analysis. Three emergent patterns of BV over 12-months were identified by RMLCA: persistent (55.9%), recurrent (30.5%) and clearance (13.5%). Participants who had douched at least once had significantly lower odds to be in the recurrent class versus the clearance class (adjusted Odds Ratio [adjOR]: 0.55; 95% Confidence Interval [CI]: 0.18–0.63). Women who had sex with women (WSW) had significantly lower odds of belonging to the persistent class versus the clearance class (adjOR: 0.38; 95% CI: 0.22–0.68) and the recurrent class (adjOR: 0.43; 95% CI: 0.23–0.81). Those who were assigned to the treatment arm had significantly increased odds of being in the recurrent class versus the clearance class (adjOR: 1.92; 95% CI: 1.22–3.03). Women >21 years were significantly more likely to be in the recurrent class (adjOR: 1.88; 95% CI: 1.17–3.00) than in the clearance class. Assessment of BV cases revealed distinct patterns of recurrence and persistence of BV which were significantly associated with douching, being in the treatment arm, and being a woman who had sex with women. Among young women with asymptomatic BV who were followed for one year, we identified factors associated with thse recurrence, persistence, or clearance of BV.