Common Vaginal Infection May Increase HIV Infection Risk Print E-mail
Medicine - Medical Horizons
Written by TS-Si News Service   
Saturday, 02 August 2008 17:00
Bacterial Vaginosis
TS-Si Medicine
Chapel Hil, NC, USA. A meta-analysis of 23 published studies, including data from more than 30,700 women worldwide, shows that women with bacterial vaginosis (BV) — the most common type of vaginosis in women of reproductive age — increased the likelihood of HIV infection. The association between was stronger for women without high-risk sexual behavior.
 
This meams that even a common vaginal infection may make women more susceptible to contracting HIV, the virus that causes AIDS. The results of the analysis have been published in the journal AIDS by School of Public Health researchers at the University of North Carolina at Chapel Hill.
 
Bacterial vaginosis and HIV acquisition: a meta-analysis of published studies. Julius Atashili, Charles Poole, Peter M Ndumbe, Adaora A Adimora, and Jennifer S Smith. AIDS 22(12) 1493-1501. ISSN: 0269-9370. Online ISSN: 1473-5571.
 
Bacterial vaginosis is an imbalance in the type of bacteria normally found in the vagina. BV has been shown to cause gynecological and obstetrical problems including preterm delivery, pelvic inflammatory disease and upper genital tract infections.
 
Jennifer S. Smith, epidemiology research assistant professor in the UNC School of Public Health."Given that bacterial vaginosis and HIV infection are both transmitted sexually, it is difficult to determine whether associations found are causal, or if there is some other reason why women with BV are more likely that others to become infected with HIV," said Jennifer S. Smith, epidemiology research assistant professor in the UNC School of Public Health. "If additional follow-up studies show that there was a relationship between BV and the risk of incident HIV infection, though, then increasing the treatment of BV could be considered for the future prevention of HIV infection."
 
Other research has shown that BV results in several changes in the vagina that could explain why it increases the risk of HIV, such as a depletion in a type of bacteria that are believed to play a role in defending the vagina against microorganisms including HIV, and higher pH levels that may increase the adherence and survival of the virus.
 
The studies analyzed by Smith and colleagues included women from Burkina Faso, Gambia, Kenya, Malawi, South Africa, South Africa, Tanzania, Thailand, Uganda, Zimbabwe, Nigeria, and the United States. The prevalence of BV in women in these countries ranged from about 11 percent to as high as 70 percent.
 
The analysis of data indicates that BV increases the risk of acquiring HIV by about 60 percent. The association between BV and HIV infection was weaker in high HIV-risk groups, Smith said. "That may be because women in high-risk groups have a greater risk of acquiring HIV from causes other than BV. This could be helpful information in identifying which populations would be helped most through targeted bacterial vaginosis control measures."
 


In addition to Jennifer S. Smith, researchers from the UNC department of epidemiology who contributed to the study included doctoral student Julius Atashili; associate professor Charles Poole; and associate professor Adaora Adimora. Peter Ndumbe of the Center for the Study and Control of Communicable Diseases, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon, was also a co-author.

 


Bacterial vaginosis and HIV acquisition: a meta-analysis of published studies. Julius Atashili, Charles Poole, Peter M Ndumbe, Adaora A Adimora, and Jennifer S Smith. AIDS 22(12) 1493-1501. ISSN: 0269-9370. Online ISSN: 1473-5571.

Abstract

Objectives. To assess and summarize the published literature on the extent to which bacterial vaginosis may increase the risk of HIV acquisition.zzzzzDesign. Meta-analysis of published studies.

Methods. Medline and other electronic databases were systematically searched for eligible publications. The association between bacterial vaginosis and incident HIV was separately analyzed from that between bacterial vaginosis and prevalent HIV. The latter was further analyzed, stratified by bacterial vaginosis diagnostic method, HIV risk profile of the study population, and whether or not adjusted estimates were presented.

Results. Twenty-three eligible publications were identified, including a total of 30 739 women. Bacterial vaginosis was associated with an increased risk of HIV acquisition in HIV-incidence studies (relative risk = 1.6, 95% confidence interval: 1.2, 2.1). All but one of 21 HIV-prevalence studies reported estimates above the null. The latter results were heterogeneous and showed some evidence of funnel plot asymmetry, precluding the estimation of a single summary measure. The association between bacterial vaginosis and HIV in prevalence studies appeared stronger for women without high-risk sexual behavior.

Conclusion. Bacterial vaginosis was consistently associated with an increased risk of HIV infection. High bacterial vaginosis prevalence may result in a high number of HIV infections being attributable to bacterial vaginosis. More prospective studies are needed to accurately evaluate the role of bacterial vaginosis in HIV acquisition in low-risk versus high-risk women. Furthermore, randomized clinical trials may be worth considering to determine the effect of bacterial vaginosis control measures on HIV acquisition.

 
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Last Updated on Saturday, 02 August 2008 16:21