CLINICAL AND MICROBIOLOGICAL CHARACTERISTICS OF SYMPTOMATIC VULVO-VAGINAL CANDIDIASIS IN HIV-SEROPOSITIVE WOMEN

Objectives-To evaluate the clinical and microbiological characteristic s of symptomatic vaginal candidiasis in Human Immunodeficiency Virus ( HIV)-seropositive women attending a gynaecologic outpatient clinic for sexually-transmitted diseases (STDs). Design-Vaginal, rectal and oral specimens from cases and controls were cultured for Candida spp. Subj ects-Eighty-four consecutive HIV-seropositive and 384 HIV-seronegative women with clinical signs of vulvovaginitis. Setting-A gynaecological out-patient clinic in Pavia, Italy. Results-The overall prevalence of vaginal candidiasis was 61.9% (52/84) in the cases and 32.3% (124/384 ; p < .001) in the controls. After adjustment by logistic regression a nalysis for confounding factors (age at first intercourse, lifetime se x partners, new partner/s in the last 6 months,type of contraceptive u sed), HIV-seropositive patients were at higher risk for both Candida a lbicans (odds ratio = 2.5; 95% confidence interval 1.31-4.69; p = 0.00 6) and Torulopsis glabrata vaginitis (OR = 3.5; 95% CI = 1.05-11.60; p = 0.04) than controls. HIV-seropositive subjects had also increased r ates of oral and rectal colonisation with Candida spp. Finally, the ti me to recurrence of vaginal infection was significantly shorter in HIV -seropositive patients than controls and was correlated with the sever ity of HIV-induced immunodepression. Conclusions-Vulvovaginal candidia sis is very common in HIV-seropositive women and its prevalence is cor related with the immunological status of the host. These patients have higher frequencies of Torulopsis glabrata vaginal infection and are m ore prone to recurrence than HIV-seronegative controls.