Royce R A, Thorp J, Granados J L, Savitz D A
University of North Carolina, Chapel Hill 27599, USA.
J Acquir Immune Defic Syndr Hum Retrovirol. 1999 Apr 1;20(4):382-6. doi: 10.1097/00042560-199904010-00009.
We investigated whether bacterial vaginosis is associated with HIV infection in pregnant women in North Carolina, U.S.A.
At 24 to 29 weeks' gestation, we recruited 724 women receiving prenatal care to provide interview information and vaginal swabs for Gram's stain scoring of vaginal flora.
As vaginal flora score increased, prevalence of HIV increased (trend p = .03). HIV prevalence was 0.8% (4 of 489 patients), 1.2% (1 of 84 patients), and 3.3% (5 of 151 patients) among women with normal, intermediate, and abnormal vaginal flora, respectively. All HIV-infected women were free from AIDS and were taking antiretroviral medication. Compared with women with normal vaginal flora, the relative risk for prevalence of HIV infection with intermediate flora was 1.5 (95% confidence interval [CI], 0.2, 12.9) and with abnormal flora was 4.0 (95% CI, 1.1, 14.9). The association between abnormal vaginal flora and HIV infection could not be explained by age, ethnicity, number of sexual partners in the past 6 months, sexually transmitted diseases (STDs), or douching during pregnancy.
In a population with a relatively low HIV prevalence, vaginal flora abnormalities were associated with prevalent HIV infection. We cannot determine whether vaginal flora abnormalities increase women's susceptibility to HIV infection or become more common after infection. The increased prevalence of bacterial vaginosis among HIV-infected pregnant women increases risk for preterm delivery. Incidence studies are required to discern whether control of bacterial vaginosis might reduce HIV infectivity.
我们调查了美国北卡罗来纳州孕妇的细菌性阴道病是否与HIV感染有关。
在妊娠24至29周时，我们招募了724名接受产前护理的妇女，以获取访谈信息并采集阴道拭子用于阴道菌群的革兰氏染色评分。
随着阴道菌群评分的增加，HIV感染率也增加（趋势p = 0.03）。阴道菌群正常、中等和异常的妇女中，HIV感染率分别为0.8%（489例患者中的4例）、1.2%（84例患者中的1例）和3.3%（151例患者中的5例）。所有感染HIV的妇女均未患艾滋病且正在接受抗逆转录病毒药物治疗。与阴道菌群正常的妇女相比，阴道菌群中等的妇女感染HIV的相对风险为1.5（95%置信区间[CI]，0.2，12.9），阴道菌群异常的妇女为4.0（95%CI，1.1，14.9）。阴道菌群异常与HIV感染之间的关联无法用年龄、种族、过去6个月的性伴侣数量、性传播疾病（STD）或孕期灌洗来解释。
在HIV感染率相对较低的人群中，阴道菌群异常与现患HIV感染有关。我们无法确定阴道菌群异常是增加了女性对HIV感染的易感性，还是在感染后变得更常见。HIV感染孕妇中细菌性阴道病患病率的增加会增加早产风险。需要进行发病率研究以确定控制细菌性阴道病是否可能降低HIV传染性。
