%0 Journal Article
%T Pregnancy in HIV-Positive Patients: Effects on Vaginal Flora
%A Cristina Vallone
%A Giuliano Rigon
%A Valeria Lucantoni
%A Lorenza Putignani
%A Fabrizio Signore
%J Infectious Diseases in Obstetrics and Gynecology
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/287849
%X A high proportion of HIV-infected pregnant women present pathogenic organisms in their lower genital tract. This has been associated with the development of postpartum morbility, HIV transmission to the partner and offspring, and other gynaecological conditions, such as cervical dysplasia or cancer. Vaginal flora alterations can range from 47% in Western countries to 89% in Africa in pregnant HIV-positive patients, much higher than about 20% of the general population. Pathogen organism retrieval is high. As peripartum complications due to vaginal infections seem higher in HIV-positive patients, accurate investigation and treatment of such infections are strongly mandatory. 1. Introduction The classification system, drawn by the Centers for Disease Control and Prevention (CDC) of HIV infection, includes several gynaecological conditions such as persistent, frequent, or poorly responsive episodes of vaginal candidiasis, from light to severe cervical intraepithelial neoplasia (CIN), pelvic inflammatory disease (PID), chronic herpes simplex virus ulcers, and invasive cervical cancer. Three of these conditions may have a strong impact on pregnancy, namely, lower genital tract neoplasia, sexually transmitted infections and vaginitis [1]. Vaginal infections during pregnancy in HIV-positive patients have been deeply investigated in some recent studies. Preliminary data indicate an association between vaginal infections, and perinatal morbility. 2. Materials and Methods Pertinent international literature was reviewed; however, due to the scarcity of studies on the matter, a systematic review resulted very difficult. We focused our attention especially on HIV-positive pregnant women. All data concerning vaginal infections during pregnancy in HIV-positive patients were thoroughly analysed. Data concerning lower genital tract intercurrent pathogens, risks of infection, perinatal complications of vaginal infections, risks of associated conditions, effects on obstetric management, and results of prevention and therapy are discussed. We report our preliminary findings on 54 pregnant HIV patients. Vaginal cultures were performed during the first and third trimester of pregnancy. Cultures included tests for chlamydia, mycoplasma gram positive and negative bacteria, candida. A smear was performed for protozoa identification, notably trichomonas. 3. Results and Discussion 3.1. Pathogenic Lower Genital Tract Organisms in HIV Pregnancy A study from a high-risk USA population on 854 HIV-infected women and 434 controls reports that the prevalence of bacterial vaginosis was
%U http://www.hindawi.com/journals/idog/2012/287849/