Joshi S, Mane A, Muwonge R, Divate U, Padbidri V, Kulkarni V, Gangakhedkar R, Sankaranarayanan R
Hirabai Cowasji Jehangir Medical Research Institute and Prayas, Pune, India.
National AIDS Research Institute, Pune, India.
Int J STD AIDS. 2020 May;31(6):541-552. doi: 10.1177/0956462419878333. Epub 2020 Mar 31.
We evaluated the prevalence and determinants of bacterial vaginosis (BV) in HIV-infected women from Maharashtra, India. Among 912 HIV-infected women enrolled, BV was diagnosed in 191 (20.9%) and intermediate BV was diagnosed in 258 (28.3%) women. Women with more than two pregnancies had 1.6 times increased risk of BV (95% CI 1.0, 2.5, p-value 0.038), women who were menopausal had 6.2 times increased risk of BV (95% CI 2.4, 15.6, p-value <0.001) and women who were human papillomavirus (HPV) positive had 2.3 times increased risk of BV (95% CI 1.4, 3.9, p-value 0.001). Although we observed significantly increased risk of BV among women diagnosed with cervical intraepithelial neoplasia or worse disease in the univariate analysis (odds ratio 3.5, 95% CI 1.5, 8.1, p-value 0.004), it did not reach statistical significance in the multivariate analysis. Women who had the first sexual intercourse after the age of 18 had significantly lower risk of BV. To conclude, we observed high prevalence of BV in HIV-infected women and increased risk of BV in HPV positive, HIV-infected women.
我们评估了印度马哈拉施特拉邦感染艾滋病毒女性中细菌性阴道病(BV)的患病率及其决定因素。在纳入研究的912名感染艾滋病毒的女性中,191名(20.9%)被诊断为BV,258名(28.3%)女性被诊断为中间型BV。怀孕超过两次的女性患BV的风险增加1.6倍(95%置信区间1.0, 2.5,p值0.038),绝经女性患BV的风险增加6.2倍(95%置信区间2.4, 15.6,p值<0.001),人乳头瘤病毒(HPV)阳性的女性患BV的风险增加2.3倍(95%置信区间1.4, 3.9,p值0.001)。虽然在单因素分析中,我们观察到被诊断为宫颈上皮内瘤变或更严重疾病的女性患BV的风险显著增加(比值比3.5, 95%置信区间1.5, 8.1,p值0.004),但在多因素分析中未达到统计学显著性。18岁以后首次发生性行为的女性患BV的风险显著降低。总之,我们观察到感染艾滋病毒的女性中BV患病率较高,HPV阳性的感染艾滋病毒女性患BV的风险增加。