Bacterial Vaginosis Associated With HIV Infection in Pregnant Women From North Carolina

Royce, Rachel A.; Thorp, John M.; Granados, Juan L.; Savitz, David A.

doi:10.1097/00042560-199904010-00009

Cited by 71 publications

(42 citation statements)

References 14 publications

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“…Moreover, it is important to consider that in addition to having poor hygiene practices, the HIV-positive women are affected by HIV-associated immunodeficiency, which predisposes the vagina to bacterial colonization and to mycoplasma colonization. In fact, an association between BV and HIV, also possibly influenced by poor vaginal hygiene, has been reported in several studies [3,5]. In our study, a significant association has been found among these factors.…”

Section: Discussionsupporting

confidence: 80%

“…BV is frequently encountered in women attending sexually transmitted infection (STI) and genitourinary medicine (GUM) or other reproductive health clinics (RHC). It has been reported that BV is also associated with poor pregnancy outcomes such as preterm delivery [2]; moreover, several studies have now reported associations between BV and HIV infection [3,4,5]. BV appears to be particularly common in sub-Saharan Africa, where HIV infection is endemic, and it has been reported at high prevalence rates (20-49%) among women presenting with vaginal discharge to STI clinics [6,7,8].…”

Section: Introductionmentioning

confidence: 99%

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HIV-infected women of Burkina Faso: a “reservoir” of mycoplasma infection

Djigma¹,

Ouédraogo²,

Sagna³

et al. 2011

J Infect Dev Ctries

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Introduction: The objective of this work was to assess the prevalence of bacterial vaginosis (BV) and genital mycoplasma colonization in 251 HIV-positive compared to 200 HIV-negative women at the Maternal and Child Health (MCH) service of Saint Camille Medical Center Ouagadougou (Burkina Faso). Methodology: After revealing the cervix with a speculum, we collected swabs of vaginal discharge for the detection of pathogenic bacteria. Results: Among HIV-positive and HIV-negative women, we identified respectively: Mycoplasma hominis (16.7% versus 5.5%); Ureaplasma urealyticum (16.3% versus 0.0%); co-infection M. hominis with U. urealyticum (13.14% versus 0.0%); Candida albicans (21.11% versus 41.5%); E. coli (9.96% versus 4.0%); and the presence of abundant vaginal discharge (27.5% versus 5.0%) respectively. The Nugent's score, utilized for the diagnosis of BV, was significantly higher in HIV-positive women (p < 0.001) associated with poor vaginal hygiene practices (p < 0.01) and no use of condoms (p < 0.01). Enterobacter, Klebsiella pneumonia, Klebsiella oxitocica, Staphylococcus epidermidis and Staphylococcus aureus, Streptococcus agalactiae, Trichomonas vaginalis, and Gardnerella vaginalis were also isolated, but in a low prevalence ranging from 0% to 5%. Conclusion: These results demonstrate that the HIV-positive women of Burkina Faso are frequently affected by BV and represent a reservoir for mycoplasma infection. Since these germs can lead to sterility and premature delivery, it is important to develop a policy of screening.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

HIV-infected women of Burkina Faso: a “reservoir” of mycoplasma infection

Djigma¹,

Ouédraogo²,

Sagna³

et al. 2011

J Infect Dev Ctries

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“…21,22 Bacterial vaginosis is another highly prevalent and largely asymptomatic condition seen at this substance abuse treatment facility. Given recent descriptions of associations of these processes with serious complications and sequelae, [23][24][25] screening for these disorders, as well as for reportable STDs, may be warranted.…”

Section: Discussionmentioning

confidence: 99%

Risk and prevalence of treatable sexually transmitted diseases at a Birmingham substance abuse treatment facility

Bachmann

Lewis²,

Allen³

et al. 2000

Am J Public Health

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OBJECTIVES: We evaluated the prevalence of gonorrhea, chlamydia, trichomoniasis, and syphilis in patients entering residential drug treatment. METHODS: Data on sexual and substance abuse histories were collected. Participants provided specimens for chlamydia and gonorrhea ligase chain reaction testing. Trichomonas vaginalis culture, and syphilis serologic testing. RESULTS: Of 311 patients, crack cocaine use was reported by 67% and multisubstance use was reported by 71%. Sexually transmitted disease (STD) risk behaviors were common. The prevalence of infection was as follows: Chlamydia trachomatis, 2.3%; Neisseria gonorrhoeae, 1.6%; trichomoniasis, 43%; and syphilis, 6%. CONCLUSIONS: STD counseling and screening may be a useful adjunct to inpatient drug treatment.

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“…It is hypothesized that the lack of hydrogen-peroxide producing lactobacilli in the vaginal flora of women with BV is the major biological risk for STD acquisition although other factors such as elevated vaginal pH and local cytokine production which accompany BV may be operative as well 5, 6, 12-14 . Crosssectional studies have documented a significant association between BV and HIV seropositivity [15][16][17] . Prospective studies have shown that HIV seroconversion is significantly associated with alterations in vaginal flora 18 .…”

Section: Commentmentioning

confidence: 99%

A randomized trial of metronidazole in asymptomatic bacterial vaginosis to prevent the acquisition of sexually transmitted diseases

Schwebke

Desmond

2007

American Journal of Obstetrics and Gynecology

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Objective-To determine if treatment of BV decrease the incidence of sexually transmitted diseases.Study Design-Women with asymptomatic BV were studied prospectively to determine the effect of treatment of BV for the prevention of STD. Women were randomized to observation or treatment and prophylaxis with intravaginal metronidazole gel. Women were screened monthly for STDs.Results-Women randomized to metronidazole gel had a significantly longer time to development of STD compared to women in the observation group (p=0.02). The 6-month STD rate was 1.58/ person-year (95% CI 1.29, 1.87) for women in the metronidazole gel group versus 2.29/person-year (95% CI 1.95, 2.63) for women in the observational group. The difference in STD rates was driven by a significant difference in the number of chlamydial infections (0.013).Conclusion-Treatment and twice-weekly prophylactic use of intravaginal metronidazole gel resulted in significantly fewer cases of chlamydia.

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Bacterial Vaginosis Associated With HIV Infection in Pregnant Women From North Carolina

Cited by 71 publications

References 14 publications

HIV-infected women of Burkina Faso: a “reservoir” of mycoplasma infection

HIV-infected women of Burkina Faso: a “reservoir” of mycoplasma infection

Risk and prevalence of treatable sexually transmitted diseases at a Birmingham substance abuse treatment facility

A randomized trial of metronidazole in asymptomatic bacterial vaginosis to prevent the acquisition of sexually transmitted diseases

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