Longitudinal analysis of bacterial vaginosis: Findings from the HIV epidemiology research study

Denise J. Jamieson, Ann Duerr, Robert S. Klein, Pangaja Paramsothy, William Brown, Susan Cu-Uvin, Anne Marie Rompalo, Jack Sobel

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To determine the natural history of bacterial vaginosis in women with or at risk for human immunodeficiency virus (HIV). METHODS: A cohort of 854 HIV-infected women and 434 HIV-uninfected women from four US sites was followed prospectively with gynecologic exams every 6 months over a 5-year period. The prevalence, incidence, persistence, and severity of bacterial vaginosis, which was defined using a Gram-staining scoring system, were calculated using generalized estimating equation methods. RESULTS: In adjusted analyses, HIV-infected women had a higher prevalence of bacterial vaginosis than HIV-uninfected women (adjusted odds ratio [OR] 1.29; 95% confidence interval [CI] 1.08, 1.55). Although HIV-infected women were not more likely to have incident infections, they were more likely to have persistence of their infections (adjusted OR 1.49; 95% CI 1.18, 1.89). Similarly, immunocompromised women (CD4+ cell count less than 200 cells/μL) were more likely than HIV-infected women with higher CD4+ cell counts (more than 500 cells/μL) to have prevalent (adjusted OR 1.29; 95% CI 1.03, 1.60) and persistent (adjusted OR 1.38; 95% CI 1.01, 1.91) bacterial vaginosis infections, but not more likely to have incident infections. Immunocompromised women had more severe bacterial vaginosis by both clinical criteria (adjusted OR 1.40; 95% CI 1.08, 1.82) and by Gram-staining criteria (adjusted OR 1.50; 95% CI 1.12, 2.00). CONCLUSIONS: Bacterial vaginosis is more prevalent and persistent among HIV-infected women, particularly among those who are immunocompromised. Immunocompromised women are more likely than HIV-infected women with higher CD4+ cell counts to have severe bacterial vaginosis.

Original languageEnglish (US)
Pages (from-to)656-663
Number of pages8
JournalObstetrics and Gynecology
Volume98
Issue number4
DOIs
StatePublished - 2001
Externally publishedYes

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Bacterial Vaginosis
Epidemiology
HIV
Research
Odds Ratio
Confidence Intervals
CD4 Lymphocyte Count
Infection
Staining and Labeling
Bacterial Infections

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Jamieson, D. J., Duerr, A., Klein, R. S., Paramsothy, P., Brown, W., Cu-Uvin, S., ... Sobel, J. (2001). Longitudinal analysis of bacterial vaginosis: Findings from the HIV epidemiology research study. Obstetrics and Gynecology, 98(4), 656-663. https://doi.org/10.1016/S0029-7844(01)01525-3

Longitudinal analysis of bacterial vaginosis : Findings from the HIV epidemiology research study. / Jamieson, Denise J.; Duerr, Ann; Klein, Robert S.; Paramsothy, Pangaja; Brown, William; Cu-Uvin, Susan; Rompalo, Anne Marie; Sobel, Jack.

In: Obstetrics and Gynecology, Vol. 98, No. 4, 2001, p. 656-663.

Research output: Contribution to journalArticle

Jamieson, DJ, Duerr, A, Klein, RS, Paramsothy, P, Brown, W, Cu-Uvin, S, Rompalo, AM & Sobel, J 2001, 'Longitudinal analysis of bacterial vaginosis: Findings from the HIV epidemiology research study', Obstetrics and Gynecology, vol. 98, no. 4, pp. 656-663. https://doi.org/10.1016/S0029-7844(01)01525-3
Jamieson, Denise J. ; Duerr, Ann ; Klein, Robert S. ; Paramsothy, Pangaja ; Brown, William ; Cu-Uvin, Susan ; Rompalo, Anne Marie ; Sobel, Jack. / Longitudinal analysis of bacterial vaginosis : Findings from the HIV epidemiology research study. In: Obstetrics and Gynecology. 2001 ; Vol. 98, No. 4. pp. 656-663.
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abstract = "OBJECTIVE: To determine the natural history of bacterial vaginosis in women with or at risk for human immunodeficiency virus (HIV). METHODS: A cohort of 854 HIV-infected women and 434 HIV-uninfected women from four US sites was followed prospectively with gynecologic exams every 6 months over a 5-year period. The prevalence, incidence, persistence, and severity of bacterial vaginosis, which was defined using a Gram-staining scoring system, were calculated using generalized estimating equation methods. RESULTS: In adjusted analyses, HIV-infected women had a higher prevalence of bacterial vaginosis than HIV-uninfected women (adjusted odds ratio [OR] 1.29; 95{\%} confidence interval [CI] 1.08, 1.55). Although HIV-infected women were not more likely to have incident infections, they were more likely to have persistence of their infections (adjusted OR 1.49; 95{\%} CI 1.18, 1.89). Similarly, immunocompromised women (CD4+ cell count less than 200 cells/μL) were more likely than HIV-infected women with higher CD4+ cell counts (more than 500 cells/μL) to have prevalent (adjusted OR 1.29; 95{\%} CI 1.03, 1.60) and persistent (adjusted OR 1.38; 95{\%} CI 1.01, 1.91) bacterial vaginosis infections, but not more likely to have incident infections. Immunocompromised women had more severe bacterial vaginosis by both clinical criteria (adjusted OR 1.40; 95{\%} CI 1.08, 1.82) and by Gram-staining criteria (adjusted OR 1.50; 95{\%} CI 1.12, 2.00). CONCLUSIONS: Bacterial vaginosis is more prevalent and persistent among HIV-infected women, particularly among those who are immunocompromised. Immunocompromised women are more likely than HIV-infected women with higher CD4+ cell counts to have severe bacterial vaginosis.",
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AU - Jamieson, Denise J.

AU - Duerr, Ann

AU - Klein, Robert S.

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AU - Brown, William

AU - Cu-Uvin, Susan

AU - Rompalo, Anne Marie

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N2 - OBJECTIVE: To determine the natural history of bacterial vaginosis in women with or at risk for human immunodeficiency virus (HIV). METHODS: A cohort of 854 HIV-infected women and 434 HIV-uninfected women from four US sites was followed prospectively with gynecologic exams every 6 months over a 5-year period. The prevalence, incidence, persistence, and severity of bacterial vaginosis, which was defined using a Gram-staining scoring system, were calculated using generalized estimating equation methods. RESULTS: In adjusted analyses, HIV-infected women had a higher prevalence of bacterial vaginosis than HIV-uninfected women (adjusted odds ratio [OR] 1.29; 95% confidence interval [CI] 1.08, 1.55). Although HIV-infected women were not more likely to have incident infections, they were more likely to have persistence of their infections (adjusted OR 1.49; 95% CI 1.18, 1.89). Similarly, immunocompromised women (CD4+ cell count less than 200 cells/μL) were more likely than HIV-infected women with higher CD4+ cell counts (more than 500 cells/μL) to have prevalent (adjusted OR 1.29; 95% CI 1.03, 1.60) and persistent (adjusted OR 1.38; 95% CI 1.01, 1.91) bacterial vaginosis infections, but not more likely to have incident infections. Immunocompromised women had more severe bacterial vaginosis by both clinical criteria (adjusted OR 1.40; 95% CI 1.08, 1.82) and by Gram-staining criteria (adjusted OR 1.50; 95% CI 1.12, 2.00). CONCLUSIONS: Bacterial vaginosis is more prevalent and persistent among HIV-infected women, particularly among those who are immunocompromised. Immunocompromised women are more likely than HIV-infected women with higher CD4+ cell counts to have severe bacterial vaginosis.

AB - OBJECTIVE: To determine the natural history of bacterial vaginosis in women with or at risk for human immunodeficiency virus (HIV). METHODS: A cohort of 854 HIV-infected women and 434 HIV-uninfected women from four US sites was followed prospectively with gynecologic exams every 6 months over a 5-year period. The prevalence, incidence, persistence, and severity of bacterial vaginosis, which was defined using a Gram-staining scoring system, were calculated using generalized estimating equation methods. RESULTS: In adjusted analyses, HIV-infected women had a higher prevalence of bacterial vaginosis than HIV-uninfected women (adjusted odds ratio [OR] 1.29; 95% confidence interval [CI] 1.08, 1.55). Although HIV-infected women were not more likely to have incident infections, they were more likely to have persistence of their infections (adjusted OR 1.49; 95% CI 1.18, 1.89). Similarly, immunocompromised women (CD4+ cell count less than 200 cells/μL) were more likely than HIV-infected women with higher CD4+ cell counts (more than 500 cells/μL) to have prevalent (adjusted OR 1.29; 95% CI 1.03, 1.60) and persistent (adjusted OR 1.38; 95% CI 1.01, 1.91) bacterial vaginosis infections, but not more likely to have incident infections. Immunocompromised women had more severe bacterial vaginosis by both clinical criteria (adjusted OR 1.40; 95% CI 1.08, 1.82) and by Gram-staining criteria (adjusted OR 1.50; 95% CI 1.12, 2.00). CONCLUSIONS: Bacterial vaginosis is more prevalent and persistent among HIV-infected women, particularly among those who are immunocompromised. Immunocompromised women are more likely than HIV-infected women with higher CD4+ cell counts to have severe bacterial vaginosis.

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