Characterizations of Bacterial Vaginosis among HIV-Positive and HIV-Negative Women in Rural Eastern Cape Province, South Africa.

Teke Apalata,Ikanyeng D Seipone,Ntombizodumo Nxasana,Sandisiwe Nojaholo,Jeferson Lourenco

doi:10.1155/2021/9913878

Teke Apalata, Ikanyeng D Seipone + Show 3 more

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https://doi.org/10.1155/2021/9913878

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Abstract

Bacterial vaginosis (BV) is extremely common among the African population and is associated with the transmission and acquisition of human immunodeficiency virus (HIV) infection. The objective of this study was to determine the prevalence and characteristics of BV among HIV-infected and -uninfected women in rural Eastern Cape province of South Africa. A descriptive cross-sectional study was conducted between September 2017 and March 2018 on women aged 18 years and above (n = 100), attending Nelson Mandela Academic Hospital and Ngangelizwe Community Health Centre with signs and symptoms suggestive of vaginal infection. High vaginal swabs were collected, and BV was diagnosed using Nugent's score. The prevalence rate of BV was 70% irrespective of HIV status. Of the 61 HIV-infected patients, 49 (80.3%) and 12 (19.7%) were BV positive and BV negative, respectively; whilst of the 39 HIV-uninfected women, 21 (53.8%) and 18 (46.2%) were BV positive and BV negative, respectively (OR = 3.5; CI: 1.4–8.5; p=0.005). Women aged above 35 years were highly likely to develop BV (p=0.049). The presence of Mobiluncus species (>25 per high microscopic field) was significantly associated with BV among HIV-infected patients (p=0.030). A recent history of antibiotic use (≤3 months) was significantly associated with BV among HIV-negative patients (p=0.044). This study shows that BV is more prevalent among HIV-positive women than their HIV-negative counterparts, and its occurrence is higher among those aged above 35 years. The predominance of Mobiluncus species in the vagina microbiota of HIV-infected women might play a significant role in the development of BV. These findings suggest that the treatment of BV could restore normal flora and reduce susceptibility to and transmission of HIV.

Highlights

Bacterial vaginosis (BV) is the most common genital infection worldwide with reported high prevalence among the African population [1, 2]. It has been associated with the transmission and acquisition of human immunodeficiency virus (HIV) infection, which poses a major problem for resource-limited Sub-Saharan Africa that bears more than 70% of the global burden of HIV infections with women accounting for 58% of the total number of people living with HIV [1, 3]
Our study showed that BV was associated with an increased risk of HIV infection among women older than 35 years of age
Bacterial vaginosis was associated with the decrease or absence of protective lactobacilli which are normally present in the vagina

Summary

Introduction

Bacterial vaginosis (BV) is the most common genital infection worldwide with reported high prevalence among the African population [1, 2]. It has been associated with the transmission and acquisition of human immunodeficiency virus (HIV) infection, which poses a major problem for resource-limited Sub-Saharan Africa that bears more than 70% of the global burden of HIV infections with women accounting for 58% of the total number of people living with HIV [1, 3]. Lactobacilli maintains the vaginal acidity or pH by producing lactic acid from glycogen, which inhibits the growth of the low level bacterial species found in the vagina such as Mobiluncus, Gardnerella, and Bacteroides. Douching, smoking, using of bubble bath, history of sexually transmitted infections (STIs), and high frequency of sexual intercourse are considered major factors playing a role in the pathogenesis of BV [7]

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