Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa; Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa; Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa.
Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa; Department of Medical Microbiology, School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa.
Ann Epidemiol. 2023 Jun;82:33-39. doi: 10.1016/j.annepidem.2023.04.004. Epub 2023 Apr 8.
We investigated the incidence, recurrence, prevalence, and risk factors for bacterial vaginosis (BV) diagnosis starting from acute HIV infection among South African women.
The Centre for the AIDS Programme of Research in South Africa 002 study tested and treated women for BV (Nugent score 7-10) once/twice annually from acute to chronic HIV infection (2004-2020). We estimated BV incidence as the number of new cases and recurrence as the number of subsequent diagnoses per 100 person-years (PYs). We fitted Anderson-Gil Cox-proportional-hazard regression models to determine factors associated with BV incidence or recurrence.
Of 235 participants, the median age at enrollment was 25 years (Inter Quartile Range [IQR] 22-29). BV prevalence at enrollment was 50.6%. BV incidence was 23.9 cases per 100 PYs, and recurrence was 51.3 cases per 100 PYs. BV incidence/recurrence was associated with younger age (<25 years: adjusted hazard ratio [aHR] 1.70, 95% confidence interval [CI] 1.27-2.27), detectable HIV viral load (aHR 1.54, 95% CI 1.27-1.87) and lower CD4 count (<350 cells/μL: aHR 1.33, 95% CI 1.01-1.76).
Our findings underscore the need for early antiretroviral treatment initiation with diagnostic BV and sexually transmitted infection care, especially among younger women.
我们调查了南非女性从急性 HIV 感染开始细菌性阴道病（BV）诊断的发生率、复发率、患病率和危险因素。
南非艾滋病研究计划中心 002 研究从急性到慢性 HIV 感染（2004-2020 年）期间，每年对女性进行一次/两次 BV（Nugent 评分 7-10）检测和治疗。我们将 BV 发生率定义为每 100 人年（PYs）新发病例数，复发率定义为随后诊断的病例数。我们拟合了安德森-吉尔 Cox 比例风险回归模型，以确定与 BV 发生率或复发率相关的因素。
在 235 名参与者中，入组时的中位年龄为 25 岁（四分位间距 [IQR] 22-29）。入组时 BV 患病率为 50.6%。BV 发生率为每 100 PYs 23.9 例，复发率为每 100 PYs 51.3 例。BV 发生率/复发率与年龄较小（<25 岁：调整后的危险比 [aHR] 1.70，95%置信区间 [CI] 1.27-2.27）、可检测到的 HIV 病毒载量（aHR 1.54，95% CI 1.27-1.87）和较低的 CD4 计数（<350 个细胞/μL：aHR 1.33，95% CI 1.01-1.76）有关。
我们的研究结果强调了需要早期启动抗逆转录病毒治疗，同时进行诊断性 BV 和性传播感染的治疗，尤其是在年轻女性中。
