Emory University School of Medicine, Atlanta, GA, USA.
J Womens Health (Larchmt). 2011 Nov;20(11):1737-41. doi: 10.1089/jwh.2011.2888. Epub 2011 Oct 19.
To examine the prevalence of and risk factors for group B Streptococcus (GBS) colonization in an HIV-infected and uninfected pregnant population.
We conducted a retrospective double cohort study comparing the prevalence of GBS colonization between 90 HIV-infected and 1947 uninfected women attending prenatal care at San Francisco General Hospital, an urban public hospital affiliated with the University of California, San Francisco. We investigated risk factors for GBS colonization, including age, ethnicity, obesity, diabetes, alcohol or illicit drug use, tobacco use, degree of immunosuppression, and infectious comorbidities.
In the multivariable analysis, HIV serostatus was not independently associated with GBS colonization (odds ratio [OR] 1.00, 95% confidence interval [CI] 0.62-1.62). Obesity (OR 1.53, 95% CI 1.13-2.07), white race (OR 1.89, 95% CI 1.30-2.75), and black race (OR 1.78, 95% CI 1.32-2.41) were independently associated with increased maternal GBS colonization. Among HIV-infected women, univariate analysis showed an association between GBS colonization and detectable HIV-1 plasma viral load at the time of rectovaginal culture (p<0.05). Mean CD4 lymphocyte count, infectious comorbidities, and HIV-1 plasma viral load at delivery were not associated with GBS colonization in HIV-infected pregnant women.
HIV-1 infection is not a risk factor for GBS colonization among an ethnically diverse pregnant population at San Francisco General Hospital, although our data suggest that among HIV-infected women, plasma HIV-1 viremia may be associated with GBS colonization. Interventions that diminish HIV-1 plasma viral load and, perhaps, genital tract shedding of HIV may be associated with a reduced risk of GBS colonization in future studies.
研究 HIV 感染和未感染孕妇人群中 B 群链球菌（GBS）定植的流行率和危险因素。
我们进行了一项回顾性双队列研究，比较了在旧金山综合医院接受产前护理的 90 名 HIV 感染和 1947 名未感染孕妇中 GBS 定植的流行率。我们调查了 GBS 定植的危险因素，包括年龄、种族、肥胖、糖尿病、酒精或非法药物使用、吸烟、免疫抑制程度和传染性合并症。
在多变量分析中，HIV 血清状态与 GBS 定植无关（比值比 [OR] 1.00，95%置信区间 [CI] 0.62-1.62）。肥胖（OR 1.53，95%CI 1.13-2.07）、白种人（OR 1.89，95%CI 1.30-2.75）和黑种人（OR 1.78，95%CI 1.32-2.41）与增加的母体 GBS 定植独立相关。在 HIV 感染的女性中，单变量分析显示 GBS 定植与直肠阴道培养时可检测到的 HIV-1 血浆病毒载量之间存在关联（p<0.05）。HIV 感染孕妇的平均 CD4 淋巴细胞计数、传染性合并症和分娩时的 HIV-1 血浆病毒载量与 GBS 定植无关。
在旧金山综合医院的种族多样化孕妇人群中，HIV-1 感染不是 GBS 定植的危险因素，尽管我们的数据表明，在 HIV 感染的女性中，血浆 HIV-1 病毒载量可能与 GBS 定植有关。在未来的研究中，减少 HIV-1 血浆病毒载量和（可能）减少 HIV 生殖道脱落的干预措施可能与降低 GBS 定植的风险有关。
