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Although most of these organisms are present in small numbers within the normal vagina, Mobiluncus pp are rarely seen in a normal vagina.

However, Gardnerella vaginalis has been reported in from 16-42% of women with no signs of symptoms of BV.

Several environmental conditions occur as a consequence of the anaerobic overgrowth including a reduced number of polyamines responsible for the characteristic odor of BV and the vaginal epithelial cell exfoliation or discharge.

Interestingly no vaginal inflammatory response has been found thus the terminology is bacterial vaginosis vs. vaginitis. However, recent research has reported a decrease in vaginal secretory leukocyte protease inhibitor and an increase in vaginal IgA degradation which may represent the mechanism responsible for the increase susceptibility to HIV among women with BV (cauci, draper).