Myer Landon, Denny Lynette, Telerant Robin, Souza Michelle de, Wright Thomas C, Kuhn Louise
Infectious Diseases Epidemiology Unit, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
J Infect Dis. 2005 Oct 15;192(8):1372-80. doi: 10.1086/462427. Epub 2005 Sep 9.
Bacterial vaginosis (BV) may increase women's susceptibility to HIV infection, but there are few prospective data.
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.
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]).
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.
细菌性阴道病（BV）可能会增加女性感染HIV的易感性，但前瞻性数据较少。
在一项宫颈癌筛查试验的5110名女性随访长达36个月期间，共识别出86名新的HIV血清转化者（病例患者）。非血清转化对照受试者（n = 324）按年龄和随访时间与病例患者进行频率匹配。在入组时，对病例患者和对照受试者进行BV临床体征评估，并使用 Nugent 标准对阴道分泌物革兰氏染色进行评分。
根据临床标准，入组时20%的血清转化者和16%的对照受试者被诊断为BV（汇总比值比[OR]，1.31[95%置信区间{CI}，0.71 - 2.41]）。74%的血清转化者和62%的对照受试者符合BV的 Nugent 标准。在调整人口统计学特征、其他性传播感染和性行为后，根据 Nugent 标准诊断为BV与HIV血清转化风险增加显著相关（调整后OR，2.01[95%CI，1.12 - 3.62]）。
在这种情况下，BV可能是新感染HIV的很大一部分原因。BV的治疗以及促进阴道正常菌群的其他干预措施对于预防HIV值得关注。
