Abstract
Objective: Mucosal infections including vulvovaginal candidiasis are a common problem for women
with human immunodeficiency virus (HIV) infection. Our objective was to determine which factors
predict the development of symptomatic disease among HIV-infected women.Materials and Methods: In a prospective study from 1991 to 1995, 205 HIV-positive women were
evaluated every 6 months for occurrences of vulvovaginal candidiasis. Included in the study were
all initially asymptomatic women, whether they were fungal-culture-positive or -negative at baseline.
Excluded from the study were all women with symptomatic vulvovaginal candidiasis at the
initial visit, those who developed trichomonas vaginitis at any visit, and those who used any antifungal
agents.Results: The risk of the development of vulvovaginal candidiasis did not differ between women
who were asymptomatically colonized at baseline and those who were fungal-culture-negative.
However, the risk of developing vulvovaginal candidiasis was increased 6.8 times for women with
CD4 counts less than 200 cells/m