Vaginal leucocyte counts in women with bacterial vaginosis: relation to vaginal and cervical infections
- 1Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- 2Jefferson County Department of Health, Birmingham, AL, USA
- Correspondence to: William M Geisler UAB STD Program, 703 19th St South, 242 Zeigler Research Building, Birmingham, AL 35294–0007, USA;
- Accepted 10 March 2004
Objectives: To evaluate whether an elevated vaginal leucocyte count in women with bacterial vaginosis (BV) predicts the presence of vaginal or cervical infections, and to assess the relation of vaginal WBC counts to clinical manifestations.
Methods: We retrospectively analysed the relation of vaginal leucocyte counts to vaginal and cervical infections and to clinical manifestations in non-pregnant women diagnosed with BV at an STD clinic visit.
Results: Of 296 women with BV studied, the median age was 24 years and 81% were African-American. Elevated vaginal leucocyte counts were associated with objective signs of vaginitis and cervicitis and also predicted candidiasis (OR 7.9, 95% CI 2.2 to 28.9), chlamydia (OR 3.1, 95% CI 1.4 to 6.7), gonorrhoea (OR 2.7, 95% CI 1.3 to 5.4), or trichomoniasis (OR 3.4, 95% CI 1.6 to 7.3). In general, as a screening test for vaginal or cervical infections, vaginal leucocyte count had moderate sensitivities and specificities, low positive predictive values, and high negative predictive values.
Conclusions: An elevated vaginal leucocyte count in women with BV was a strong predictor of vaginal or cervical infections. Vaginal leucocyte quantification may provide an alternative approach to assessing need for empirical therapy for chlamydia and gonorrhoea, particularly in resource-limited high STD risk settings that provide syndromic management.
- BV, bacterial vaginosis
- OCP, oral contraceptive pill
- VVC, vulvovaginal candidiasis
- WBCs, white blood cells
Funding: William M Geisler is supported by the Centers for Disease Control and Prevention Sexually Transmitted Disease Faculty Expansion Program Grant R30- CCR421113.
Conflicts of interest: none.
Presented in part at the International Society for Sexually Transmitted Disease Research Congress, July 2003, Ottawa.