Abstract
Aim and Objectives: To study prevalence of bacterial vaginosis in HIV seropositive females, Consorts of HIV positive males and control group and association of other reproductive tract infections with bacterial vaginosis and assessment of progression of HIV infection in bacterial vaginosis positive patients by CD 4 cell count.Method: This prospective randomized study was carried out at STD Clinic, Zenana Hospital with approval from Hospital Ethics Committee and informed written consent from patients.50 HIV seropositive women, 25 seronegative consorts of HIV positive males and 50 control patients were included in the study. All the patients under study were subjected to Grams staining of the vaginal smear, Pap smear and Colposcopy. HPV DNA testing was done in all HIV positive patients and seronegative consorts of HIV positive males. In control group only patients showing dyskaryotic changes on cytology were subjected to colposcopy. All HIV seropositive women were subjected to additional tests of CD 4 and CD 8 cell counts.Result: Prevalence of bacterial vaginosis was high in HIV positive women (36%) as compared to HIV negative group (24%). Prevalence was significantly higher in HIV positive patients with CD 4 cell count less than 200 per microlitre that is 77.77 % with P value (0.007) which is highly significant statistically.Conclusion: In bacterial vaginosis, vaginal eco-system is altered. It increases risk of infection by opportunistic pathogens when the host defences became impaired .Hence it is concluded that bacterial vaginosis should be treated effectively in patients who are at high risk of acquiring HIV infection and wide spread control of bacterial vaginosis can become a tool for decreasing incidence of HIV in developing countries.
Highlights
Vagina has a dynamic ecosystem.The vaginal pH in premenarchal female is 7
Recent studies suggest that bacterial vaginosis may increase a woman’s risk for human immunodeficiency virus (HIV)
As the proportion of women acquiring HIV through heterosexual transmission continues to increase, emerging research demonstrates an association between the presence of bacterial vaginosis and increased susceptibility to HIV
Summary
Vagina has a dynamic ecosystem.The vaginal pH in premenarchal female is 7. Bacterial Vaginosis is a polymicrobial syndrome involving replacement of normal vaginal lactobacilli with concentration of Gardenerella vaginalis, Mobilincus species, Mycohominis, Anaerobic gram negative rod belonging to Prevotella, Porphyromonas, Bacteroids and Peptostreptococcus species. Gardenerella vaginalis has been found in 45% to 98%, Anaerobic gram negative rod in 53% to 76%, Peptostreptoccocus in 29% to 63%, Mycohominis in 58%to 76% and Mobilincus in 51% of Bacterial Vaginosis cases and www.ssjournals.com. 0% in controls; Whereas lactobacilli have generally been found in 9% to 38% of Bacterial vaginosis cases and 68% to 90% of controls.[1]. As the proportion of women acquiring HIV through heterosexual transmission continues to increase, emerging research demonstrates an association between the presence of bacterial vaginosis and increased susceptibility to HIV
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