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Query: UMLS:C0001175 (AIDS)
 120,706 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Over a four-month study period, 87 patients requesting termination of pregnancy at a gynaecology clinic were offered screening for sexually transmitted diseases, of whom 63 accepted. A total of 41 infections were found in 34 women, the commonest being vaginal candidiasis and bacterial vaginosis. Chlamydia was found in six patients. Although HIV antibody testing was offered to every patient, all declined this test.
Int J STD AIDS
PMID:Screening for lower genital tract infections in women presenting for termination of pregnancy. 806 Oct 94

The presence of amines in vaginal fluid is thought to be an important contributory factor in the pathogenesis of bacterial vaginosis (BV). As part of on-going work investigating the aetiology of this infection, two separate studies were performed in which gas chromatography was used to measure and compare the amines present in the vaginal secretions of normal women, a group infected with BV and some having other sexually transmitted diseases. The amines studied were methylamine, isobutylamine, putrescine, cadaverine and phenylethylamine. The results of the studies were contrary to expectations, in that they showed an overall similarity in both normal women and in those with BV and other vaginal infections. These findings now bring in to question the validity of amines being a reliable focus, either in the diagnosis of BV, or in investigations into the aetiology of the disease.
Int J STD AIDS
PMID:The determination of amines in the vaginal secretions of women in health and disease. 814 29

Of 6125 women attending an STD clinic from 1988 to 1991, 5365 (88%) were tested for vaginitis of whom 97 (1.8%) had trichomoniasis, 945 (17.6%) had candidiasis, 734 (13.7%) had bacterial vaginosis and 3628 (67.6%) were free of vaginal infection. Dual infections occurred in 49 (0.9%) patients. Independent predictors for trichomoniasis by multivariate analysis were being pregnant (odds ratio (OR) = 2.4), having vaginal discharge or dysuria (OR = 4.7), being Aboriginal (OR = 4.3), being Asian (OR = 5.0), being unemployed (OR = 2.1) or tattoed (OR = 1.9). Many factors, including use of oral contraception (OR = 1.2) and current antibiotic medication (OR = 1.5), had a small significant association with candidiasis. Independent predictors for bacterial vaginosis were having multiple sex partners in the past month (OR = 1.6), being unmarried (OR = 1.5), being unemployed (OR = 1.3) being a prostitute (OR = 1.5) and not currently using antibiotic medication (OR = 2.5). The epidemiological profiles were consistent with trichomoniasis and bacterial vaginosis being sexually transmitted diseases with epidemiology different from that of gonorrhoea and chlamydia and different from each other, and candidiasis being a disease in which constitutional factors are more important than issues relating to sexual transmission.
Int J STD AIDS
PMID:Factors associated with trichomoniasis, candidiasis and bacterial vaginosis. 842 98

To explore a possible association between bacterial vaginosis and human immunodeficiency virus (HIV) infection, 144 consecutively enrolled commercial sex workers from a sexually transmitted disease clinic (STD) in Chiang Mai, Thailand, were interviewed and underwent serologic testing and genital examination. 62 (43%) of sex workers were HIV-positive. A self-reported history of syphilis, chancroid, herpes, gonorrhea, or Chlamydia was significantly associated with HIV infection. Bacterial vaginosis, detected in 49 (34%), was also associated with HIV infection. Sex workers reporting 10-19 and 20 or more sexual encounters per week were 2.2 and 3.5 times, respectively, more likely to be infected with HIV than those reporting under 10 encounters. A clinically established diagnosis of bacterial vaginosis was independently associated with HIV seropositivity even when age, number of sexual encounters per week, current condom use, and past and current STD infection were controlled (odds ratio, 4.0; 95% confidence interval, 1.7-9.4). When the bacterial vaginosis diagnosis was based on Gram stain (score 7-10), however, the association with HIV seropositivity disappeared, but having abnormal vaginal flora (gram stain score 4-10) was related to HIV status. Further epidemiologic studies are recommended to investigate the possibility that bacterial vaginosis--the most prevalent genital infection in Thailand--acts as a cofactor for the heterosexual transmission of HIV.
AIDS 1995 Sep
PMID:Bacterial vaginosis and HIV seroprevalence among female commercial sex workers in Chiang Mai, Thailand. 852 84

Induced abortion is one of the most frequent surgical procedures in the UK. Even though it is considered safe, it sometimes has complications and long-term sequelae. Pelvic inflammatory disease (PID) is the most prevalent complication and can lead to chronic pelvic pain, pain during intercourse, infertility, and a higher risk of ectopic pregnancy. Chlamydia trachomatis is perhaps the leading etiologic agent for PID among women who have undergone induced abortion and who develop PID. Gonorrhea is another major etiologic agent for PID. Strategies used to try to reduce pelvic infection revolve around administration of antibiotic prophylaxis based on demographic features and on the presence of certain organisms in the genital tract that may increase their risk (e.g., C. trachomatis and Neisseria gonorrhoeae) and universal antibiotic prophylaxis for all women undergoing abortion. Most of the literature suggests that antibiotic prophylaxis does provide some protection against PID but does not clearly indicate who should be screened and for which pathogens and who should be treated and with which antibiotics. Demographic features useful for identifying who should receive antibiotic prophylaxis are: a history of PID, single status, nulliparity, and youth (especially reliable for chlamydial infection). Screening for bacterial vaginosis involves diagnosis based on 3 of 4 criteria: characteristic vaginal discharge, positive amine test, raised vaginal pH, and the presence of clue cells on microscopy of wet or stained preparations of vaginal discharge. Since C. trachomatis is the most important pathogen, drugs sensitive to it should be administered: tetracyclines and erythromycin. Screening women seeking abortion for sexually transmitted diseases (STDs) provides an opportunity to educate them about STDs and treatment compliance and to contact their partners for investigation, treatment, and contact-tracing to reduce the STD-infected pool in the community.
Int J STD AIDS
PMID:Preventing pelvic infection after abortion. 854 9

The role of sexual transmission of microorganisms in bacterial vaginosis (BV) is controversial. If sexual intercourse were a risk factor for BV, then we would expect that women with BV would also be coinfected with other sexually transmitted diseases (STD). We investigated the prevalence of STD among pregnant women a low socio-economic status with bacterial vaginosis in Indonesia. Among these women, 23.3% had at least one STD (chlamydia, gonorrhoea, syphilis or trichomoniasis). Chlamydial infection was the most prevalent (19.5%), followed by trichomoniasis (3.8%), gonorrhoea (3.2%) and syphilis (0.4%). Compared to the rates of STD observed in a previous study of all pregnant women (with or without BV) in Indonesia, pregnant women with BV have more than a 2-fold increase in chlamydia (19.5% vs 8.2%) and a 6-fold increase in gonorrhoea (3.2% vs 0.5%). Because detection of BV by Gram stain is easy to perform and economical, detection of BV has potential as a prescreening marker for chlamydia and gonorrhoea among asymptomatic pregnant women of low socio-economic status in Indonesia. Further work is needed to evaluate the usefulness of BV as a prescreening marker for chlamydia and gonorrhoea.
Int J STD AIDS
PMID:Coinfection with chlamydia and gonorrhoea among pregnant women and bacterial vaginosis. 865 16

Women constitute the fastest growing segment of adults with acquired immunodeficiency syndrome (AIDS), representing 18% of all cases in the United States in 1994. Heterosexual transmission is now the dominant route by which women are infected. Recent reports indicate that although certain manifestations may be different in women than in men, the rate of clinical progression is similar when they receive comparable medical treatment. Antiretroviral therapy is equally as effective in women as in men. As in men, Pneumocystis carinii pneumonia is the most frequent AIDS-defining diagnosis in women. Candida esophagitis and ulcers secondary to herpes simplex virus are more common in women. Kaposi's sarcoma is rare. The prevalence of humanpapilloma virus infection and cervical neoplasia is increased in HIV-seropositive women. Vaginitis due to candida, trichomonas, and bacterial vaginosis are common findings among human immunodeficiency virus seropositive women. The clinical course and response to therapy in certain sexually transmitted diseases (syphilis and herpes) may be altered. The use of zidovudine during pregnancy and delivery has been associated with a 67.5% reduction in vertical transmission.
 ...
PMID:Human immunodeficiency virus infection and acquired immunodeficiency syndrome among North American women. 887 94

The history of bacterial vaginosis (BV), now extending over more than 40 years, has been remarkable not only in terms of repeatedly changing the name of the bacterium that we now know as Gardnerella vaginalis but also in relation to what is thought to constitute the condition, what it should be called and how the diagnosis can best be made. The composite clinical criteria are often confusing for the nonspecialist, provide room for inter-observer error, and misinterpretation of just one criterion can lead to considerable over or under diagnosis. There is no doubt that diagnosis should be through a Gram-stained vaginal smear, allowing detection not only of 'full blown' BV but also patterns of vaginal flora that while not in this category are nevertheless abnormal. Accurate diagnosis is important in view of the ever-growing list of other important conditions that may occur as a consequence of the abnormal flora. In addition to this, we raise the question of whether the name and abbreviation BV is the best either scientifically or from the point of view of the lay public. While recognizing that it now may be too ingrained for further change, is it possible to have a better term, at least for lay use?
Int J STD AIDS 1996 Jul
PMID:Defining bacterial vaginosis: to BV or not to BV, that is the question. 887 52

Bacterial vaginosis (BV) is a common cause of abnormal malodorous vaginal discharge and can be frustrating to manage in its recurrent form. Metronidazole is the standard treatment, but is unacceptable to many women when given repeatedly. Results of treating recurrent BV using a single vaginal washout with 3% hydrogen peroxide are analysed. A total of 30 symptomatic women with clinically confirmed recurrent BV in the absence of other genital infections were recruited after informed consent. Hydrogen peroxide (3%) was instilled into the vagina, left for 3 minutes and drained. Reassessment was at 3 weeks after treatment. A total of 23 women completed the study. Symptoms cleared completely in 78% (18/23), improved in 13% (3/23) and remained unchanged in 9% (2/23). All the 3 women with improved symptoms had a mild vaginal discharge, but only one of them was still able to perceive the malodour. The amine test was negative in all 23 women including the 2 (9%) who felt no change in their symptoms following treatment. Mixed anaerobes isolated in all women before treatment were not re-isolated, and microscopy did not show 'clue cells' in the vaginal discharge following treatment. Vaginal acidity was restored to normal in all but one (96%). No side-effects were observed in the treated women. Hydrogen peroxide (3%) used as a single vaginal wash was as effective as any other agent in current use in clearing the vaginal malodour of bacterial vaginosis at 3 weeks after treatment.
Int J STD AIDS 1996 Jul
PMID:Recurrent bacterial vaginosis--an old approach to a new problem. 908 37

Healthy female volunteers participated in an anonymous study to monitor vaginal flora by taking daily vaginal samples and making a smear for later Gram-staining, as well as recording information on genital symptoms, sexual activity, contraceptive and bathing practices. A modification of Spiegel's criteria was used to categorize the Gram-stained smears, an intermediate category between normal flora and bacterial vaginosis (BV) being recognized. Of the 22 volunteers who completed the study, one was excluded because of pregnancy. Of the remaining 21 women, 10 (48%) had a normal flora throughout the study, 4 (19%) had an abnormal flora throughout and 7 (33%) had a basically normal flora which underwent a change to either an intermediate flora in 5 women or fully developed BV in 2 of them. In 5 (71%) of these women the change occurred within the first 9 days of the cycle. Transient changes in the vaginal microbial flora occurred predominantly in the first part of the menstrual cycle which suggests that in some women hormonal changes could have a role in the pathogenesis of bacterial vaginosis.
Int J STD AIDS 1997 Aug
PMID:A longitudinal study of the vaginal flora over a menstrual cycle. 925 96


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