From the Department of Epidemiology, Robert Stempel College of Public Health and Social Work.
Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, Miami.
Sex Transm Dis. 2020 Dec;47(12):832-839. doi: 10.1097/OLQ.0000000000001256.
Although risk factors of recurrent and persistent bacterial vaginosis (BV) have been explored in the literature, the longitudinal incidence patterns of BV remain elusive.
We conducted a secondary analysis of longitudinal data from a randomized clinical trial of metronidazole treatment for asymptomatic BV. Repeated-measures latent class analysis was used to identify distinct longitudinal patterns of incident BV cases. Multinomial regression analysis was used to determine the predictors of class membership. The multivariable model included age, last BV treatment, douching frequency, birth control, sexual risk behavior, and assignment to treatment arm.
A total of 858 African American women who were asymptomatic for BV were included in the analysis. Three emergent patterns of BV for 12 months were identified by repeated-measures latent class analysis: persistent (55.9%), recurrent (30.5%), and clearance (13.5%). Participants who had douched at least once had significantly lower odds to be in the recurrent class versus the clearance class (adjusted odds ratio [adjOR], 0.55; 95% confidence interval [CI], 0.18-0.63). Women who had sex with women had significantly lower odds of belonging to the persistent class versus the clearance class (adjOR, 0.38; 95% CI, 0.22-0.68) and the recurrent class (adjOR, 0.43; 95% CI, 0.23-0.81). Those who were assigned to the treatment arm had significantly increased odds of being in the recurrent class versus the clearance class (adjOR, 1.92; 95% CI, 1.22-3.03). Women older than 21 years were significantly more likely to be in the recurrent class (adjOR, 1.88; 95% CI, 1.17-3.00) than in the clearance class.
Assessment of BV cases revealed distinct patterns of recurrence and persistence of BV, which were significantly associated with douching, being in the treatment arm, and being a woman who had sex with women.
尽管文献已经探讨了复发性和持续性细菌性阴道病（BV）的危险因素，但 BV 的纵向发病模式仍不清楚。
我们对甲硝唑治疗无症状 BV 的随机临床试验的纵向数据进行了二次分析。重复测量潜在类别分析用于识别 BV 病例的不同纵向发病模式。多变量回归分析用于确定类别归属的预测因素。多变量模型包括年龄、上次 BV 治疗、冲洗频率、避孕、性行为风险和治疗手臂分配。
共纳入 858 名无症状 BV 的非裔美国女性进行分析。通过重复测量潜在类别分析确定了 12 个月内三种 BV 持续模式：持续性（55.9%）、复发性（30.5%）和清除性（13.5%）。至少冲洗过一次的参与者与清除组相比，复发性组的可能性显著降低（调整后的优势比[adjOR]，0.55；95%置信区间[CI]，0.18-0.63）。与女性发生性关系的女性与清除组相比，持续性组（adjOR，0.38；95%CI，0.22-0.68）和复发性组（adjOR，0.43；95%CI，0.23-0.81）的可能性显著降低。被分配到治疗组的女性与清除组相比，复发性组的可能性显著增加（adjOR，1.92；95%CI，1.22-3.03）。年龄大于 21 岁的女性与清除组相比，复发性组的可能性显著增加（adjOR，1.88；95%CI，1.17-3.00）。
评估 BV 病例发现了 BV 复发和持续存在的不同模式，这些模式与冲洗、处于治疗组和女性发生性行为的风险因素显著相关。
