A prospective study of vaginal trichomoniasis and HIV-1 shedding in women on antiretroviral therapy

BMC Infectious Diseases

R Scott McClelland⁵  Julie Overbaugh²  Barbra A Richardson²  Kishorchandra Mandaliya³  Jeckoniah O Ndinya-Achola⁵  Walter Jaoko⁵  Nobert Peshu⁴  Ruth Gitau⁵  Susan M Graham⁴  Linnet N Masese¹ 

[1]Department of Epidemiology, Box 357236, University of Washington, Seattle, Washington 98195, USA

[2]Division of Human Biology, Fred Hutchinson Cancer Research Center, P.O. Box 19024, Seattle, Washington 98109, USA

[3]Coast Provincial General Hospital, P.O. Box 90231, Mombasa, Kenya

[4]Kenya Medical Research Institute, P.O. Box 230-80108, Kilifi, Kenya

[5]Department of Medical Microbiology, University of Nairobi, P.O. Box 30197-00100, Nairobi, Kenya

关键词: Africa;    women;    HIV-1;    antiretroviral therapy;    vaginal infection;    Trichomonas vaginalis;   

Others  :  1175542
DOI  :  10.1186/1471-2334-11-307

 received in 2010-09-16, accepted in 2011-11-03,  发布年份 2011

【 摘 要 】

Background

Trichomonas vaginalis has been associated with increased vaginal HIV-1 RNA shedding in antiretroviral therapy (ART)-naïve women. The effect of trichomoniasis on vaginal HIV-1 shedding in ART-treated women has not been characterized. We tested the hypothesis that T. vaginalis infection would increase vaginal HIV-1 RNA shedding in women on ART, and that successful treatment would reduce vaginal HIV-1 RNA levels.

Methods

We conducted a prospective cohort study including monthly follow-up of 147 women receiving ART in Mombasa, Kenya. Those with T. vaginalis infection, defined by the presence of motile trichomonads on vaginal saline wet mount, received treatment with single dose metronidazole (2 g). Test of cure was performed at the next monthly visit. Using the pre-infection visit as the reference category, we compared detection of vaginal HIV-1 RNA before versus during and after infection using generalized estimating equations. A cut-off of 100 HIV-1 RNA copies/swab was used as the lower limit for linear quantitation.

Results

Among 31 women treated for trichomoniasis, the concentration of vaginal HIV-1 RNA was above the limit for quantitation before, during, and after T. vaginalis infection in 4 (13% [95% CI 4% - 30%]), 4 (13% [95% CI 4% - 30%]), and 5 (16% [95% confidence interval {CI} 5% - 34%]) women respectively. After adjusting for potential confounding factors, we could detect no difference in the likelihood of detecting vaginal HIV-1 RNA before versus during infection (odds ratio [OR] 1.41, 95% CI 0.23 - 8.79, p = 0.7). In addition, detection of HIV-1 RNA was similar before infection versus after successful treatment (OR 0.68, 95% CI (0.13 - 3.45), p = 0.6).

Conclusion

Detection of vaginal HIV-1 RNA during ART was uncommon at visits before, during and after T. vaginalis infection.

【 授权许可】

   
2011 Masese et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 3.

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