Hester Robin A, Kennedy Stephen B
Minority International Research Training (MIRT) Program, Department of International Health, University of Alabama School of Public Health, Birmingham, Alabama, USA.
J Womens Health (Larchmt). 2003 Jun;12(5):487-94. doi: 10.1089/154099903766651612.
Numerous epidemiological studies have documented that ulcerative sexually transmitted diseases (STDs), such as syphilis, chancroid, and genital herpes, promote heterosexual human immunodeficiency virus (HIV) transmission. However, the role of vaginal inflammations, such as Candida infection, in HIV acquisition has not been well established, even though, like Trichomona vaginalis infection, it is rapidly emerging as a significant co-factor in HIV transmission.
This study was conducted among a high-risk population of heterosexual women, cohabitating with their HIV-positive male partners, to determine if an association exists between vaginal infections, primarily Candida, and HIV seroconversion. These serodiscordant couples (i.e., one of the persons is HIV positive, and the other is HIV negative) are currently enrolled in an ongoing longitudinal heterosexual discordant couple cohort that is being prospectively followed at Project Sans Francisco (PSF), an HIV Prevention and Research Center in Lusaka, Zambia. A nested case-control study that used retrospective laboratory analyses data obtained from medical, clinical, and laboratory records at PSF was employed.
The findings from this study clearly document that women who seroconverted from HIV-negative status during baseline to HIV-positive status at follow-up were significantly more likely to have vaginal Candida infections than were the correspondingly matched seronegative control women.
These findings suggest that high-risk heterosexual HIV-negative women could benefit from appropriate gynecological management and care regarding the prevention and treatment of vaginal Candida infections, especially in resource-poor environments.
大量流行病学研究表明，梅毒、软下疳和生殖器疱疹等溃疡性性传播疾病会促进异性间人类免疫缺陷病毒（HIV）的传播。然而，尽管念珠菌感染等阴道炎症与阴道毛滴虫感染一样，正迅速成为HIV传播的一个重要协同因素，但它在HIV感染中的作用尚未完全明确。
本研究在与HIV阳性男性伴侣同居的高危异性恋女性人群中进行，以确定阴道感染（主要是念珠菌感染）与HIV血清转化之间是否存在关联。这些血清学不一致的伴侣（即一方为HIV阳性，另一方为HIV阴性）目前参与了一项正在进行的纵向异性恋不一致伴侣队列研究，该研究在赞比亚卢萨卡的HIV预防与研究中心“旧金山计划”（PSF）进行前瞻性跟踪。采用了一项巢式病例对照研究，利用从PSF的医疗、临床和实验室记录中获取的回顾性实验室分析数据。
本研究结果清楚地表明，在随访期间从基线HIV阴性状态血清转化为HIV阳性状态的女性比相应匹配的血清阴性对照女性更有可能患有阴道念珠菌感染。
这些发现表明，高危异性恋HIV阴性女性可能会从针对阴道念珠菌感染的预防和治疗的适当妇科管理与护理中受益，尤其是在资源匮乏的环境中。
