OBJECTIVES: To assess and summarize the published literature on the extent to which bacterial vaginosis may increase the risk of HIV acquisition. DESIGN: 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.
OBJECTIVES: To assess and summarize the published literature on the extent to which bacterial vaginosis may increase the risk of HIV acquisition. DESIGN: 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.
Authors: K Fonck; R Kaul; J Kimani; F Keli; K S MacDonald; A R Ronald; F A Plummer; P Kirui; J J Bwayo; E N Ngugi; S Moses; M Temmerman Journal: Int J STD AIDS Date: 2000-12 Impact factor: 1.359
Authors: S Rugpao; T Nagachinta; C Wanapirak; J Srisomboon; V Suriyanon; B Sirirojn; O Chaiyarassamee; W Prasertwitayakij; D D Celentano; K E Nelson; S D Vernon; A Duerr Journal: Int J STD AIDS Date: 1998-11 Impact factor: 1.359
Authors: C R Cohen; F A Plummer; N Mugo; I Maclean; C Shen; E A Bukusi; E Irungu; S Sinei; J Bwayo; R C Brunham Journal: AIDS Date: 1999-02-25 Impact factor: 4.177
Authors: S L Hillier; R P Nugent; D A Eschenbach; M A Krohn; R S Gibbs; D H Martin; M F Cotch; R Edelman; J G Pastorek; A V Rao Journal: N Engl J Med Date: 1995-12-28 Impact factor: 91.245
Authors: Jacqueline E Rudolph; Stephen R Cole; Joseph J Eron; Angela D Kashuba; Adaora A Adimora Journal: Epidemiology Date: 2019-05 Impact factor: 4.822
Authors: Jordan K Kyongo; Tania Crucitti; Joris Menten; Liselotte Hardy; Piet Cools; Johan Michiels; Sinead Delany-Moretlwe; Mary Mwaura; Gilles Ndayisaba; Sarah Joseph; Raina Fichorova; Janneke van de Wijgert; Guido Vanham; Kevin K Ariën; Vicky Jespers Journal: Clin Vaccine Immunol Date: 2015-03-11
Authors: Michele N Austin; Lorna K Rabe; Sujatha Srinivasan; David N Fredricks; Harold C Wiesenfeld; Sharon L Hillier Journal: Anaerobe Date: 2014-12-04 Impact factor: 3.331