Prevalence and incidence of gynecologic disorders among women infected with human immunodeficiency virus

Howard L. Minkoff, Debra Eisenberger-Matityahu, Joseph Feldman, Robert D. Burk, Lorraine Clarke

Research output: Contribution to journalArticle

81 Citations (Scopus)

Abstract

OBJECTIVE: Our purpose was to ascertain the prevalence, incidence, and predictors of gynecologic disorders among women infected with human immunodeficiency virus. STUDY DESIGN: We serially assessed 292 women infected with human immunodeficiency virus and 681 uninfected women. Outcomes were incidence and prevalence of sexually transmitted diseases, viral shedding, findings of Papanicolaou smears, fungal infections, and menstrual disorders. RESULTS: Women infected with the virus were more likely to have prevalent vulvovaginal candidiasis (odds ratio 1.80, 95% confidence interval 1.0-3.25, P = .05), oncogenic human papillomavirus (odds ratio 3.79, 95% confidence interval 2.43-5.91, P = .001), abnormal Papanicolaou smears (odds ratio 5.40, 95% confidence interval 3.35-8.78, P = .001), amenorrhea (4.8% vs 0%, P = .05), positive results on Treponema pallidum hemagglutination assay (odds ratio 1.83, 95% confidence interval 1.16-2.88, P= .01), infection with cytomegalovirus (odds ratio 4.2, 95% confidence interval 1.82-10.62, P = .001), and genital warts (odds ratio 6.93, 95% confidence interval 3.16- 16.30, P = .001) but were less likely to have Chlamydia trachomatis infection (odds ratio 0.28, 95% confidence interval 0.10-0.66, P = .01). Annual incidence rates among women infected with human immunodeficiency virus were 4.0% for candidiasis, 22.0% for oncogenic human papillomavirus, 11.4% for genital warts, 1.7% for infection with C trachomatis, 1.7% for infection with Neisseria gonorrhoeae, 10.3% for Trichomonas vaginalis, 1.1% for positive results on T pallidum hemagglutination assay, 7.4% for an abnormal Papanicolaou smear, and 10.9% for infection with herpes simplex virus. Overall, 46.9% had at least 1 incident condition. Women infected with human immunodeficiency virus were more likely to have incident oncogenic human papillomavirus infection (odds ratio 2.0, 95% confidence interval 1.01-3.8), abnormal Papanicolaou smears (odds ratio 7.76, 95% confidence interval 2.08- 42.8), and genital warts (odds ratio 9.32, 95% confidence interval 3.04- 38.0). Incidence and prevalence of sexually transmitted diseases and oncogenic human papillomavirus infection increased with increased CD4+ cell counts. CONCLUSIONS: Women infected with the human immunodeficiency virus are significantly more likely to have prevalent and incident gynecologic disorders but not disorders related to risk taking (eg, incident sexually transmitted diseases). The latter disorders increased in women with CD4+ cell counts >500 cells/mm3. Clinicians should be aware of these patterns so that they can provide appropriate evaluation and treatment of gynecologic disorders.

Original languageEnglish (US)
Pages (from-to)824-836
Number of pages13
JournalAmerican Journal of Obstetrics and Gynecology
Volume180
Issue number4
DOIs
StatePublished - 1999
Externally publishedYes

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Odds Ratio
HIV
Confidence Intervals
Incidence
Papanicolaou Test
Condylomata Acuminata
Sexually Transmitted Diseases
Papillomavirus Infections
Hemagglutination
CD4 Lymphocyte Count
Infection
Vulvovaginal Candidiasis
Virus Shedding
Treponema pallidum
Trichomonas vaginalis
Chlamydia Infections
Globus Pallidus
Mycoses
Neisseria gonorrhoeae
Candidiasis

Keywords

  • Gynecologic disorders
  • Human immunodeficiency virus
  • Women

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

Cite this

Prevalence and incidence of gynecologic disorders among women infected with human immunodeficiency virus. / Minkoff, Howard L.; Eisenberger-Matityahu, Debra; Feldman, Joseph; Burk, Robert D.; Clarke, Lorraine.

In: American Journal of Obstetrics and Gynecology, Vol. 180, No. 4, 1999, p. 824-836.

Research output: Contribution to journalArticle

Minkoff, Howard L. ; Eisenberger-Matityahu, Debra ; Feldman, Joseph ; Burk, Robert D. ; Clarke, Lorraine. / Prevalence and incidence of gynecologic disorders among women infected with human immunodeficiency virus. In: American Journal of Obstetrics and Gynecology. 1999 ; Vol. 180, No. 4. pp. 824-836.
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T1 - Prevalence and incidence of gynecologic disorders among women infected with human immunodeficiency virus

AU - Minkoff, Howard L.

AU - Eisenberger-Matityahu, Debra

AU - Feldman, Joseph

AU - Burk, Robert D.

AU - Clarke, Lorraine

PY - 1999

Y1 - 1999

N2 - OBJECTIVE: Our purpose was to ascertain the prevalence, incidence, and predictors of gynecologic disorders among women infected with human immunodeficiency virus. STUDY DESIGN: We serially assessed 292 women infected with human immunodeficiency virus and 681 uninfected women. Outcomes were incidence and prevalence of sexually transmitted diseases, viral shedding, findings of Papanicolaou smears, fungal infections, and menstrual disorders. RESULTS: Women infected with the virus were more likely to have prevalent vulvovaginal candidiasis (odds ratio 1.80, 95% confidence interval 1.0-3.25, P = .05), oncogenic human papillomavirus (odds ratio 3.79, 95% confidence interval 2.43-5.91, P = .001), abnormal Papanicolaou smears (odds ratio 5.40, 95% confidence interval 3.35-8.78, P = .001), amenorrhea (4.8% vs 0%, P = .05), positive results on Treponema pallidum hemagglutination assay (odds ratio 1.83, 95% confidence interval 1.16-2.88, P= .01), infection with cytomegalovirus (odds ratio 4.2, 95% confidence interval 1.82-10.62, P = .001), and genital warts (odds ratio 6.93, 95% confidence interval 3.16- 16.30, P = .001) but were less likely to have Chlamydia trachomatis infection (odds ratio 0.28, 95% confidence interval 0.10-0.66, P = .01). Annual incidence rates among women infected with human immunodeficiency virus were 4.0% for candidiasis, 22.0% for oncogenic human papillomavirus, 11.4% for genital warts, 1.7% for infection with C trachomatis, 1.7% for infection with Neisseria gonorrhoeae, 10.3% for Trichomonas vaginalis, 1.1% for positive results on T pallidum hemagglutination assay, 7.4% for an abnormal Papanicolaou smear, and 10.9% for infection with herpes simplex virus. Overall, 46.9% had at least 1 incident condition. Women infected with human immunodeficiency virus were more likely to have incident oncogenic human papillomavirus infection (odds ratio 2.0, 95% confidence interval 1.01-3.8), abnormal Papanicolaou smears (odds ratio 7.76, 95% confidence interval 2.08- 42.8), and genital warts (odds ratio 9.32, 95% confidence interval 3.04- 38.0). Incidence and prevalence of sexually transmitted diseases and oncogenic human papillomavirus infection increased with increased CD4+ cell counts. CONCLUSIONS: Women infected with the human immunodeficiency virus are significantly more likely to have prevalent and incident gynecologic disorders but not disorders related to risk taking (eg, incident sexually transmitted diseases). The latter disorders increased in women with CD4+ cell counts >500 cells/mm3. Clinicians should be aware of these patterns so that they can provide appropriate evaluation and treatment of gynecologic disorders.

AB - OBJECTIVE: Our purpose was to ascertain the prevalence, incidence, and predictors of gynecologic disorders among women infected with human immunodeficiency virus. STUDY DESIGN: We serially assessed 292 women infected with human immunodeficiency virus and 681 uninfected women. Outcomes were incidence and prevalence of sexually transmitted diseases, viral shedding, findings of Papanicolaou smears, fungal infections, and menstrual disorders. RESULTS: Women infected with the virus were more likely to have prevalent vulvovaginal candidiasis (odds ratio 1.80, 95% confidence interval 1.0-3.25, P = .05), oncogenic human papillomavirus (odds ratio 3.79, 95% confidence interval 2.43-5.91, P = .001), abnormal Papanicolaou smears (odds ratio 5.40, 95% confidence interval 3.35-8.78, P = .001), amenorrhea (4.8% vs 0%, P = .05), positive results on Treponema pallidum hemagglutination assay (odds ratio 1.83, 95% confidence interval 1.16-2.88, P= .01), infection with cytomegalovirus (odds ratio 4.2, 95% confidence interval 1.82-10.62, P = .001), and genital warts (odds ratio 6.93, 95% confidence interval 3.16- 16.30, P = .001) but were less likely to have Chlamydia trachomatis infection (odds ratio 0.28, 95% confidence interval 0.10-0.66, P = .01). Annual incidence rates among women infected with human immunodeficiency virus were 4.0% for candidiasis, 22.0% for oncogenic human papillomavirus, 11.4% for genital warts, 1.7% for infection with C trachomatis, 1.7% for infection with Neisseria gonorrhoeae, 10.3% for Trichomonas vaginalis, 1.1% for positive results on T pallidum hemagglutination assay, 7.4% for an abnormal Papanicolaou smear, and 10.9% for infection with herpes simplex virus. Overall, 46.9% had at least 1 incident condition. Women infected with human immunodeficiency virus were more likely to have incident oncogenic human papillomavirus infection (odds ratio 2.0, 95% confidence interval 1.01-3.8), abnormal Papanicolaou smears (odds ratio 7.76, 95% confidence interval 2.08- 42.8), and genital warts (odds ratio 9.32, 95% confidence interval 3.04- 38.0). Incidence and prevalence of sexually transmitted diseases and oncogenic human papillomavirus infection increased with increased CD4+ cell counts. CONCLUSIONS: Women infected with the human immunodeficiency virus are significantly more likely to have prevalent and incident gynecologic disorders but not disorders related to risk taking (eg, incident sexually transmitted diseases). The latter disorders increased in women with CD4+ cell counts >500 cells/mm3. Clinicians should be aware of these patterns so that they can provide appropriate evaluation and treatment of gynecologic disorders.

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KW - Human immunodeficiency virus

KW - Women

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