Factors associated with vaginal yeast infections in HIV-positive women.
To better understand factors associated with symptomatic and asymptomatic vulvovaginal candidiasis, including the role of immune compromise and patient self-report, a cross-sectional analysis of factors associated with the isolation of yeast from vaginal swabs and clinical diagnosis of Candida vaginitis (CV) among 184 HIV-infected women was conducted. Sixty-four (35%) of the women had vaginal swabs positive for yeast. Nineteen (10%) women met the case definition for CV. In a logistic regression model, only CD4 < or = 100 cells/mm3 was predictive of CV (adds ratio = 4.5; 95% confidence interval = 1.0, 20; p = .05). The predictive value of patient self-report of CV was only 12%. This study demonstrates that all HIV-infected women should receive a regular and thorough gynecologic evaluation, regardless of self-reported symptoms. HIV-infected women will benefit from education about prevention and treatment of CV, and women whose CD4 counts are low may wish to consider prophylaxis for CV.
Williams
A B
AB
Yale School of Nursing, New Haven, CT 06536-0740, USA.
Andrews
S
S
Tashima
K
K
Mezger
J
J
Yu
C
C
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000276:immunology / Q000451:nursing* / Q000517:prevention & control; D000328:Adult; D000367:Age Factors; D018791:CD4 Lymphocyte Count; D002181:Candidiasis, Vulvovaginal / Q000175:diagnosis* / Q000276:immunology / Q000451:nursing* / Q000517:prevention & control; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D016387:Women's Health