Insights and advances in recurrent vulvovaginal candidiasis

Abstract

Vulvovaginal candidiasis (VVC, colloquially referred to as a "yeast infection") is a vaginal fungal disease that is most common in females between 20 and 50 years old The colloquial term "yeast" refers to the clinical syndrome and is the technical word for the typical morphology of the causative species. It is commonly stated that 75% of women will have at least 1 VVC episode, with 5% to 10% developing recurrent vulvovaginal candidiasis ("RVVC") These statistics may underestimate the true incidence of R/VVC (i.e., referring to both VVC and RVVC). Recent global analyses of RVVC epidemiology estimated that 138 million women are annually affected However, their analyses also highlighted that few to no robust global studies track women for at least 1 year with reliable clinical and microbiological data, and they hypothesize that prevalence and incidence are probably higher than assessed and increasing due to a growing at-risk population R/VVC significantly affects morbidity and quality of life, with women incurring physical pain and elevated levels of depression and anxiety, including between symptomatic episodes The economic impact on individuals and healthcare systems is also considerable, with global estimated losses of approximately $14 billion due to a decline in productivity It is unclear why most VVC infections are successfully cleared after a single course of drug treatment, while a subset of women incur relapse of symptomatic episodes even during long-term maintenance treatment or after the cessation of therapy ([5] and references within). Whether symptomatic relapse is typically due to the population expansion of persistent vaginal yeast following treatment or reinfection remains unknown Yeast can be a common member of the vaginal and gastrointestinal microbiome

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