Determinants of symptomatic vulvovaginal candidiasis among human immunodeficiency virus type 1 infected women in rural KwaZulu-Natal, South Africa.
Determinants of symptomatic vulvovaginal candidiasis among human immunodeficiency virus type 1 infected women in rural KwaZulu-Natal, South Africa.
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DOI：
10.1155/2014/387070
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发表时间：
2014-01-01
影响因子：
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通讯作者：
Moodley, Prashini
中科院分区：
文献类型：
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作者：
Apalata, Teke;Carr, William H;Moodley, Prashini
前言：我们试图确定HIV引起的免疫抑制、病毒学相关性和外阴阴道念珠菌病(VVC)之间的关系。方法：这是一项回顾性队列研究，研究对象为HIV感染和未感染的女性，VVC为主要结果。2011年6月至12月期间，登记了97名感染艾滋病毒的妇女和101名未感染艾滋病毒的妇女。确诊为VVC病例。结果：97例HIV感染者中52例(53.6%)和38例非HIV感染者中38例(37.6%)被诊断为VVC(P=0.032)。HIV感染者发生VVC的相对危险度为1.53(95%CI：1.04-2，P=0.024)。当CD_4~+T细胞数低于200个/mm(P<；0.0001)和血浆HIVRNA载量高于10000拷贝/毫升(P<；0.0001)时，VVC病例数增加。VVC与生殖器HIV感染有关(P=0.002)，血浆HIV载量与生殖器HIV感染呈直线相关(r=0.540；R(2)=0.292；P<；0.0001)。接受抗逆转录病毒疗法的妇女发生VVC的可能性降低4/4(P=0.029)。结论：CD_4细胞数低于200个/mm(3)和血浆HIV载量≥为10000拷贝/毫升与VVC显著相关。
INTRODUCTION: We sought to determine the association between HIV-induced immunosuppression, virologic correlates, and vulvovaginal candidiasis (VVC).METHODS: This is a retrospective cohort study, where HIV infected and uninfected women were studied with VVC being the primary outcome. Ninety-seven HIV-infected and 101 HIV-uninfected women were enrolled between June and December 2011. Cases of VVC were confirmed. HIV RNA load was determined by RT-PCR and CD4 counts were obtained from medical records.RESULTS: Fifty-two of 97 (53.6%) HIV-infected and 38/101 (37.6%) HIV-uninfected women were diagnosed with VVC (P = 0.032). The relative risk for VVC amongst HIV-infected patients was 1.53 (95% CI: 1.04-2 P = 0.024). Cases of VVC increased at CD4+ T cell count below 200cells/mm(3) (P < 0.0001) and plasma HIV RNA load above 10 000copies/mL (P < 0.0001). VVC was associated with increased genital shedding of HIV (P = 0.002), and there was a linear correlation between plasma HIV load and genital HIV shedding (r = 0.540; R (2) = 0.292; P < 0.0001). Women on HAART were 4-fold less likely (P = 0.029) to develop VVC.CONCLUSION: CD4 counts below 200cells/mm(3) and plasma HIV loads ≥10 000copies/mL were significantly associated with VVC.