Bacterial vaginosis and susceptibility to HIV infection in South African women: A nested case-control study
Bacterial vaginosis and susceptibility to HIV infection in South African women: A nested case-control study
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DOI：
10.1086/462427
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发表时间：
2005-10-15
影响因子：
6.4
通讯作者：
Kuhn, L
中科院分区：
文献类型：
--
作者：
Myer, L;Denny, L;Kuhn, L
背景资料。细菌性阴道病(BV)可能增加女性感染HIV的易感性，但前瞻性数据很少。在长达36个月的随访中，在参加宫颈癌筛查试验的5110名妇女中，发现了86名新的艾滋病毒血清转换者(病例患者)。非血清转换对照组受试者(n=324)与病例患者的年龄和随访时间相匹配。在登记时，对病例患者和对照受试者进行BV临床体征评估，并根据纽金特标准对阴道液的革兰氏染色进行评分。在20%的血清转换者和16%的对照受试者中，BV的诊断基于临床标准(汇总优势比[OR]，1.31[95%可信区间{CI}，0.71-2.41])。74%的血清转换者和62%的对照受试者符合BV的Nugent标准。在调整了人口学特征、其他性传播感染和性行为后，基于Nugent标准的BV诊断与HIV血清转换风险的增加显著相关(调整后的OR，2.01[95%CI，1.12~3.62])。在这种情况下，BV可能占新的艾滋病毒感染的很大一部分。治疗BV和其他促进正常阴道菌群的干预措施值得注意，以预防艾滋病毒。
Background. Bacterial vaginosis ( BV) may increase women's susceptibility to HIV infection, but there are few prospective data.Methods. During follow-up for up to 36 months, 86 new HIV seroconverters ( case patients) were identified among 5110 women enrolled in a cervical cancer screening trial. Nonseroconverting control subjects (n = 324) were frequency matched to case patients by age and duration of follow-up. At enrollment, case patients and control subjects were evaluated for clinical signs of BV, and Gram stains of vaginal fluid were scored using Nugent criteria.Results. BV was diagnosed on the basis of clinical criteria at enrollment in 20% of seroconverters and 16% of control subjects ( summary odds ratio [ OR], 1.31 [ 95% confidence interval {CI}, 0.71-2.41]). Nugent criteria for BV were met by 74% of seroconverters and 62% of control subjects. Diagnosis of BV on the basis of Nugent criteria was significantly associated with an increased risk of HIV seroconversion, after adjustment for demographic characteristics, other sexually transmitted infections, and sexual behaviors ( adjusted OR, 2.01 [ 95% CI, 1.12-3.62]).Conclusions. BV may account for a substantial fraction of new HIV infections in this setting. Treatment of BV and other interventions to promote normal vaginal flora warrant attention for HIV prevention.