What other tests are indicated in the workup of bacterial vaginosis (BV)?

Updated: Oct 25, 2018
  • Author: Philippe H Girerd, MD; Chief Editor: Michel E Rivlin, MD  more...
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Answer

Recent research indicates that genital cytokine profiles may be used as a biomarker of sexually transmitted infections (STIs) and BV to identify women with asymptomatic, treatable infections, which may allow improvement in treatment of these conditions and possibly reduce the risk of HIV infection in high-risk women. [18]  Masson et al found that that evaluating clinical signs/symptoms in conjunction with evaluation of IL-1beta and IP-10 as biomarkers of genital inflammation is more sensitive and specific than clinical signs/symptoms alone (increased IL-1beta and decreased IP-10 concentrations). [18]

Although metronidazole is a first-line agent for treatment of BV, it is not unusual for treatment failure and recurrent disease to occur. [3] Of the four clades in the population structure of G vaginalis clades 1 and 3 are associated with BV. Schyuler et al found that metronidazole resistance was highly associated with clade 3 (<0.0001) compared to clade 1, which may have treatment implications. [3]

Abramovici et al suggest that quantitative polymerase chain reaction (qPCR) bacterial load measurement is useful in the evaluation of BV treatment response and the risk of preterm birth in pregnant women. [19] The investigators found that qPCR correlated with Nugent score and demonstrated decreased bacterial load after antibiotic treatment.


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