Vaginal colonization with Candida spp. in human immunodeficiency virus-infected women: a cohort study.
We have conducted a longitudinal study on factors associated with candidal vaginal colonization, a precursor of vaginitis, in a cohort of HIV-infected women in Italy. All consecutive women attending a single, tertiary care clinical site were offered free screening for sexually transmitted infections and genital disorders every 6-12 months. Candidal vaginal colonization was defined as a positive culture for Candida spp. in an asymptomatic woman. From January 1998 to July 2002 we analysed 214 women. The baseline prevalence of candidal vaginal colonization was 16.8%. In the logistic regression analysis, the time since HIV infection > or =36 months (odds ratio [OR] = 0.18, 95% confidence interval [CI] 0.016-0.53, P = 0.002) and a plasma viral load > or =10,000 copies/mL (OR = 3.9, 95% CI 1.03-14.9, P = 0.045) were independently associated with candidal colonization. Among 130 women who were followed for a mean period of 24 months, the incidence of vaginal colonization was 10.7/100 women-years. In the Cox regression analysis, a CD4(+) T-lymphocytes count <100 cells/microL during the follow-up was associated with an increased risk of candidal vaginal colonization (OR = 4.45, C.I. = 1.20-16.81, P = 0.03). Risk of candidal vaginal colonization episodes in HIV-infected women significantly increase when CD4(+) T-lymphocytes are less than 100.
Beltrame
Anna
A
Department of Medical and Morphological Research, University of Udine, Italy.
Matteelli
Alberto
A
Carvalho
Anna Cristina C
AC
Saleri
Nuccia
N
Casalini
Caterina
C
Capone
Susanna
S
Patroni
Andrea
A
Manfrin
Maria
M
Carosi
Giampiero
G
D000328:Adult; D018791:CD4 Lymphocyte Count; D002181:Candidiasis, Vulvovaginal / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008137:Longitudinal Studies; D008403:Mass Screening; D015995:Prevalence; D016016:Proportional Hazards Models; D011446:Prospective Studies; D019562:Viral Load; D016387:Women's Health