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Vitamin D Deficiency and Bacterial Vaginosis among HIV-infected and -uninfected Women in the United States
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Reported by Jules Levin
17th CROI, Feb 16-19 2010 SF
Audrey French1,2, O Adeyemi1,2, D Agniel2, M Yin3, K Anastos4, and M Cohen1,2
1Rush Univ Med Ctr, Chicago, IL, US; 2CORE Ctr, Stroger Hosp of Cook County, Chicago, IL, US; 3Columbia Univ Med Ctr, New York, NY, US; and 4Montefiore Med Ctr, Bronx, NY, US
Background: Bacterial vaginosis (BV), the most frequent cause of vaginitis, is associated with morbidities such as premature labor and increased susceptibility to HIV. Recently an association between vitamin D deficiency (VDD) and BV was identified in pregnant women. We sought to replicate this finding in the Women’s Interagency HIV Study (WIHS).
Method: A cross-sectional study of women participating in the WIHS, a longitudinal study of women with and at risk for HIV. Women in this substudy were from Chicago or New York. BV was defined by the Amsel criteria. VDD was defined as 25 (OH) D ≤20 ng/mL and insufficiency as >20 and ≤30 ng/mL.
Results: Among 609 women studied (6 of whom were pregnant), BV was found in 19% (table). VDD was found in 60% and insufficiency in 23.5%. VDD was associated with black race, 268 of 397 vs 59 of 92 for whites, OR 3.16 (95%CI, 2.06 to 4.89), but not with HIV status, CD4, or age. Vitamin D level strongly correlated with BV (r= –0.14, P <0.001) and there was a dose response relationship; BV was most likely in women with VDD (OR 3.55), then women with insufficient levels (OR 2.12) compared with sufficient vitamin D. In multivariate analysis black race, AOR 6.03, VDD, AOR 2.46, and number of sex partners, AOR 1.54, were independently associated with BV.
Conclusions: In this study of 609 HIV-infected and -uninfected women, BV and VDD were common and significantly correlated. VDD may partially explain the relationship between black race and BV and may be a modifiable risk factor for the disorder. Further study is needed to determine whether repletion of vitamin D will decrease the occurrence of BV.
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