Risk factors for recurrent vulvovaginal candidiasis in women receiving maintenance antifungal therapy: Results of a prospective cohort study

Division of Infectious Diseases, Wayne State University, Detroit, Michigan, United States
American Journal of Obstetrics and Gynecology (Impact Factor: 4.7). 04/2004; 190(3):644-53. DOI: 10.1016/j.ajog.2003.11.027
Source: PubMed


The purpose of this study was to examine risk factors for symptomatic vulvovaginal candidiasis episodes among women with recurrent vulvovaginal candidiasis (defined as >/=4 vulvovaginal candidiasis episodes in 1 year) who were receiving maintenance antifungal therapy.
A prospective study of 65 women aged >/=18 years with recurrent vulvovaginal candidiasis who attended vaginitis clinics in Detroit, Mich, and Philadelphia, Pa.
The 9-month risk of vulvovaginal candidiasis recurrence was 41.8%. Almost two fifths of the women reported activity limitations because of vulvovaginal candidiasis episodes, most or all of the time. Younger women and those women with a history of bacterial vaginosis were at increased risk of vulvovaginal candidiasis episodes. Behavioral factors that were associated significantly with increasing vulvovaginal candidiasis recurrence >/=2- fold included wearing pantyliners or pantyhose and consuming cranberry juice or acidophilus-containing products.
The use of pantyliners or pantyhose, consumption of cranberry juice or acidophil-containing products, a history of bacterial vaginosis, and age <40 years were positively associated with a symptomatic vulvovaginal candidiasis episode.

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Available from: Paul Nyirjesy, Jul 25, 2014
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    • "Rylander et al (2004) found an association between sweets consumption and a positive culture of Candida (71). Patel et al (2004) noted that consumption of cranberry was associated with a ≥2 risk of RVVC (51). Donders et al (2002) opined that diets rich in refined sugar may increase the risk of genital candidiasis (76). "
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    DESCRIPTION: Review Article, based on clinical experience, and challenges in mamanging patients presenting with RVVC in the context of a developing country, with limited resources and competing health priorities
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    • "According to this study [2], self-medication with antimycotics further increased the risk of recurrent infection in women who used daily panty liners. It is noteworthy that the study that showed negative consequences of the use of panty liners [14] did not evaluate healthy women but women with recurrent candidiasis. This indicates that the combination of risk factors is more important than isolated individual risk factors. "
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    ABSTRACT: Background Whether panty liners predispose to vulvovaginitis is unclear. Objectives To clarify the effects of the use of panty liners on the female genital tract. Search strategy Several electronic databases (including PubMed and Embase) were searched to identify studies published in English before May 3, 2012. Selection criteria Case–control studies, randomized controlled trials, and cohort studies comparing young women who did and did not use panty liners in the intermenstrual period were included. Data collection and analysis The quality of the studies was assessed using the Newcastle–Ottawa Scale or the Jadad Scale. Data from suitable studies were extracted for analysis. Main results Five articles met the inclusion criteria. Four studies—all of which included only healthy women—found no significant clinical implications arising from the use of panty liners. The fifth study was of women with recurrent candidiasis and showed that use of panty liners was associated with new candidiasis episodes. Conclusions The intermenstrual use of panty liners does not seem to have a negative effect on the vulvovaginal area.
    International Journal of Gynecology & Obstetrics 10/2014; 127(1). DOI:10.1016/j.ijgo.2014.06.017 · 1.54 Impact Factor
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    ABSTRACT: To assess the association between candida and HIV infections in women from different socio-economic backgrounds, vaginal swabs were collected from 510 women (aged 9 -83 years) attending secondary healthcare units in southern part of Benue State, Nigeria. Candida albicans was identified by microscopy. Candida infection rate was higher among HIV-infected women (88.8%, n = 116) than among HIV negative subjects (58.6%, n = 394) (Χ 2 = 36.077, p < 0.05; odds ratio = 5.59, 95% confidence interval (CI) = 3.03 -10.297). Candida (yeast) infection was significantly associated with HIV infection in pregnant subjects (r = 0.504, p < 0.05), married (r = .290, p < 0.05), and unmarried women (r = 0.259, p < 0.05); in married women (and also unmarried women) vaginal yeast infection was significantly correlated/associated with HIV infection (p < 0.05). In other words, the higher the number of married women who were HIV+, the higher the number with candidal yeast infection; in women ≤ 39 years old (r = 0.399, p < 0.05), civil servants (r = 0.328, p < 0.05), self/unemployed (r = 0.281, p < 0.05), and among university and secondary school students (r = 0.263, p < 0.05). All diabetic women (100%, n=106) had yeast infection, although only 3.8% of them were HIV-infected. Intervention programmes against yeast infections in HIV-infected women should be targeted at the vulnerable groups of women.
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