Influence of HIV-1 coinfection on effective management of abnormal vaginal discharge.
BACKGROUND
Reports on microbiologic cure rates following syndromic management (SM) of women with nonulcerative sexually transmitted infections (STIs) are limited.


OBJECTIVE
The goal of the study was to determine the effectiveness of the drugs used in SM of nonulcerative STIs and bacterial vaginosis in women and to compare the response among those with and without HIV-1 coinfection.


METHODS
This was a cohort study of women with nonulcerative STIs who were treated according to local SM protocols.


RESULTS
Of 692 women recruited, 415 (80%) returned 8 to 10 days later, and 290 (70%) consented to a second examination, in which specimens were obtained. Clinical cure was reported by 67%, and microbiologic cure ranged from 80% to 89% for the three discharge-causing STIs and was independent of HIV-1 status. Only 38% of those with bacterial vaginosis were cured, and HIV-1-infected women were less likely to be cured (28% versus 52%; P < 0.001).


CONCLUSIONS
Clinical and microbiologic response to SM of the nonulcerative STIs was not affected by HIV-1 coinfection, but cure rates for bacterial vaginosis were reduced.
Moodley
Prashini
P
Africa Centre for Population Studies and Reproductive Health, Faculty of Medicine, University of Natal, Durban, South Africa.
Wilkinson
David
D
Connolly
Cathy
C
Sturm
A Willem
AW
D000293:Adolescent; D000328:Adult; D000818:Animals; D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents / Q000008:administration & dosage*; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D002939:Ciprofloxacin / Q000008:administration & dosage; D015331:Cohort Studies; D004318:Doxycycline / Q000008:administration & dosage; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections; D015497:HIV-1; D006801:Humans; D008795:Metronidazole / Q000008:administration & dosage; D008875:Middle Aged; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D015995:Prevalence; D013019:South Africa / Q000453:epidemiology; D016896:Treatment Outcome; D014246:Trichomonas vaginalis / Q000302:isolation & purification; D014627:Vaginitis / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology / Q000469:parasitology
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D008795:Metronidazole; D002939:Ciprofloxacin; D004318:Doxycycline