Determinants of Symptomatic Vulvovaginal Candidiasis among Human Immunodeficiency Virus Type 1 Infected Women in Rural KwaZulu-Natal, South AfricaReportar como inadecuado




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Infectious Diseases in Obstetrics and Gynecology - Volume 2014 2014, Article ID 387070, 10 pages -

Clinical Study

Department of Infection Prevention and Control and Medical Microbiology, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Private Bag 7, Congella, Durban 4013, South Africa

Department of Medical Microbiology, Faculty of Health Sciences, Walter Sisulu University, Private Bag X1, Mthatha, Eastern Cape 5117, South Africa

HIV Pathogenesis Programme HPP, Department of Paediatrics and Child Health, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Private Bag 7, Congella, Durban 4013, South Africa

Department of Biology, Medgar Evers College, City University of New York, Brooklyn, NY 11225, USA

Received 13 May 2013; Revised 11 November 2013; Accepted 17 December 2013; Published 8 April 2014

Academic Editor: Harold Wiesenfeld

Copyright © 2014 Teke Apalata et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. We sought to determine the association between HIV-induced immunosuppression, virologic correlates, and vulvovaginal candidiasis VVC. Methods. This is a retrospective cohort study, where HIV infected and uninfected women were studied with VVC being the primary outcome. Ninety-seven HIV-infected and 101 HIV-uninfected women were enrolled between June and December 2011. Cases of VVC were confirmed. HIV RNA load was determined by RT-PCR and CD4 counts were obtained from medical records. Results. Fifty-two of 97 53.6% HIV-infected and 38-101 37.6% HIV-uninfected women were diagnosed with VVC . The relative risk for VVC amongst HIV-infected patients was 1.53 95% CI: 1.04–2 . Cases of VVC increased at CD4+ T cell count below 200 cells-mm

and plasma HIV RNA load above 10 000 copies-mL . VVC was associated with increased genital shedding of HIV , and there was a linear correlation between plasma HIV load and genital HIV shedding ; ; . Women on HAART were 4-fold less likely to develop VVC. Conclusion. CD4 counts below 200 cells-mm

and plasma HIV loads ≥10 000 copies-mL were significantly associated with VVC.





Autor: Teke Apalata, William H. Carr, Willem A. Sturm, Benjamin Longo-Mbenza, and Prashini Moodley

Fuente: https://www.hindawi.com/



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