Aetiological Pattern of Vulvovaginal Infections in Asymptomatic and Symptomatic HIV Seropositive Women on Antiretroviral Therapy
Introduction: Human Immunodeficiency Virus (HIV) causes severe public health problems. Despite the use of Highly Active Antiretroviral Therapy (HAART), opportunistic infections remain a serious problem in HIV infection. HIV seropositive women are at a higher risk of acquiring Vulvovaginal Infect...
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doaj-6f74c2229ea14eeea072cd7895dd2e872021-05-21T10:53:13ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2020-10-011410DC11DC1610.7860/JCDR/2020/44998.14084Aetiological Pattern of Vulvovaginal Infections in Asymptomatic and Symptomatic HIV Seropositive Women on Antiretroviral Therapy Divya Garg0Shukla Das1AG Radhika2Alpana Raizada3Vishal Gaurav4Rituparna Saha5Siddharth Sonthalia6Richa Anjleen Tigga7MBBS 3rd Year Student, Department of Microbiology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.Director, Professor, Department of Microbiology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.Director, Professor, Department of Obstetrics and Gynaecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.Professor, Department of Medicine, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.Postgraduate Student, Department of Dermatology and STD, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.Senior Resident, Department of Microbiology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.Director and Senior Consultant, Department of Dermatology, SKINNOCENCE, Gurugram, Haryana; New Delhi, Delhi, India.Senior Resident, Department of Microbiology, Rajiv Gandhi Super Speciality Hospital, Delhi, India.Introduction: Human Immunodeficiency Virus (HIV) causes severe public health problems. Despite the use of Highly Active Antiretroviral Therapy (HAART), opportunistic infections remain a serious problem in HIV infection. HIV seropositive women are at a higher risk of acquiring Vulvovaginal Infections (VVI), compared to their HIV seronegative counterparts. Also, the large untreated asymptomatic populations remain a source for transmitting agent. Aim: To identify the occurrence of vaginitis in symptomatic and asymptomatic HIV seropositive women. Materials and Methods: HIV seropositive female patients (60 symptomatic and 60 asymptomatic for vulvovaginitis) in the reproductive age group of 18-60 years were screened for their vaginal flora in a tertiary care hospital in East Delhi, India. Wet mount, Gram stain, and culture were performed to screen the samples for vaginitis. Asymptomatic samples were processed to check for asymptomatic VVI. Nugent and Amsel’s score were calculated for Bacterial Vaginitis (BV), and Donders classification was used for Aerobic Vaginitis (AV). Sabouraud’s Dextrose Agar (SDA) was used for fungal cultures, and Fluconazole and Voriconazole sensitivity was tested. The descriptive analysis of compiled data with Chi-square tests where applicable to compare differences between proportions was done. Results: As per the Nugent's score, 90% of symptomatic and 86.66% asymptomatic HIV reactive females had BV. Nugent scoring was found to be a better diagnostic criterion for BV. AV was observed in 33.33% asymptomatic patients. Candida albicans (C.albicans) was the most common agent isolated from 68.75% of Vulvovaginal Candidiasis (VVC) cases. Dual infection of BV and Candidiasis was reported to be 18.33% in symptomatic and 15% in asymptomatic HIV seropositive females. Conclusion: In the present study, despite Antiretroviral Therapy (ART), attendees manifested significantly with BV infection in both groups. VVC due to C. albicans was also predominant in both groups. Co-infection with BV and VVC was the highlight of this study as dual infections of BV and AV remain underdiagnosed as per Sexually Transmitted Infection (STI) syndromic management protocols. The clinicians need to identify AV as a separate entity as treatment modalities are essentially different.https://jcdr.net/articles/PDF/14084/44998_CE[Ra1]_F(SHU)_PF1(AG_KM)_PFA(KM)_PB(AG_KM)_PN(SL).pdfbacterial vaginosishuman immunodeficiency virusnugent’s scorevaginal infections |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Divya Garg Shukla Das AG Radhika Alpana Raizada Vishal Gaurav Rituparna Saha Siddharth Sonthalia Richa Anjleen Tigga |
spellingShingle |
Divya Garg Shukla Das AG Radhika Alpana Raizada Vishal Gaurav Rituparna Saha Siddharth Sonthalia Richa Anjleen Tigga Aetiological Pattern of Vulvovaginal Infections in Asymptomatic and Symptomatic HIV Seropositive Women on Antiretroviral Therapy Journal of Clinical and Diagnostic Research bacterial vaginosis human immunodeficiency virus nugent’s score vaginal infections |
author_facet |
Divya Garg Shukla Das AG Radhika Alpana Raizada Vishal Gaurav Rituparna Saha Siddharth Sonthalia Richa Anjleen Tigga |
author_sort |
Divya Garg |
title |
Aetiological Pattern of Vulvovaginal Infections in Asymptomatic and Symptomatic HIV Seropositive Women on Antiretroviral Therapy |
title_short |
Aetiological Pattern of Vulvovaginal Infections in Asymptomatic and Symptomatic HIV Seropositive Women on Antiretroviral Therapy |
title_full |
Aetiological Pattern of Vulvovaginal Infections in Asymptomatic and Symptomatic HIV Seropositive Women on Antiretroviral Therapy |
title_fullStr |
Aetiological Pattern of Vulvovaginal Infections in Asymptomatic and Symptomatic HIV Seropositive Women on Antiretroviral Therapy |
title_full_unstemmed |
Aetiological Pattern of Vulvovaginal Infections in Asymptomatic and Symptomatic HIV Seropositive Women on Antiretroviral Therapy |
title_sort |
aetiological pattern of vulvovaginal infections in asymptomatic and symptomatic hiv seropositive women on antiretroviral therapy |
publisher |
JCDR Research and Publications Private Limited |
series |
Journal of Clinical and Diagnostic Research |
issn |
2249-782X 0973-709X |
publishDate |
2020-10-01 |
description |
Introduction: Human Immunodeficiency Virus (HIV) causes
severe public health problems. Despite the use of Highly Active
Antiretroviral Therapy (HAART), opportunistic infections remain
a serious problem in HIV infection. HIV seropositive women
are at a higher risk of acquiring Vulvovaginal Infections (VVI),
compared to their HIV seronegative counterparts. Also, the
large untreated asymptomatic populations remain a source for
transmitting agent.
Aim: To identify the occurrence of vaginitis in symptomatic and
asymptomatic HIV seropositive women.
Materials and Methods: HIV seropositive female patients
(60 symptomatic and 60 asymptomatic for vulvovaginitis) in the
reproductive age group of 18-60 years were screened for their
vaginal flora in a tertiary care hospital in East Delhi, India. Wet
mount, Gram stain, and culture were performed to screen the
samples for vaginitis. Asymptomatic samples were processed
to check for asymptomatic VVI. Nugent and Amsel’s score were
calculated for Bacterial Vaginitis (BV), and Donders classification
was used for Aerobic Vaginitis (AV). Sabouraud’s Dextrose
Agar (SDA) was used for fungal cultures, and Fluconazole and
Voriconazole sensitivity was tested. The descriptive analysis
of compiled data with Chi-square tests where applicable to
compare differences between proportions was done.
Results: As per the Nugent's score, 90% of symptomatic and
86.66% asymptomatic HIV reactive females had BV. Nugent
scoring was found to be a better diagnostic criterion for BV. AV was
observed in 33.33% asymptomatic patients. Candida albicans
(C.albicans) was the most common agent isolated from 68.75%
of Vulvovaginal Candidiasis (VVC) cases. Dual infection of BV
and Candidiasis was reported to be 18.33% in symptomatic
and 15% in asymptomatic HIV seropositive females.
Conclusion: In the present study, despite Antiretroviral Therapy
(ART), attendees manifested significantly with BV infection in
both groups. VVC due to C. albicans was also predominant in
both groups. Co-infection with BV and VVC was the highlight
of this study as dual infections of BV and AV remain underdiagnosed as per Sexually Transmitted Infection (STI) syndromic
management protocols. The clinicians need to identify AV as a
separate entity as treatment modalities are essentially different. |
topic |
bacterial vaginosis human immunodeficiency virus nugent’s score vaginal infections |
url |
https://jcdr.net/articles/PDF/14084/44998_CE[Ra1]_F(SHU)_PF1(AG_KM)_PFA(KM)_PB(AG_KM)_PN(SL).pdf |
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