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

BMC Infectious Diseases

Research Article

Kishorchandra Mandaliya¹  Barbra A Richardson²  Linnet N Masese³  R Scott McClelland⁴  Ruth Gitau⁵  Walter Jaoko⁵  Jeckoniah O Ndinya-Achola⁵  Susan M Graham⁶  Julie Overbaugh⁷  Nobert Peshu⁸ 

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

[2]Department of Biostatistics, University of Washington, Box 357232, 98195, Seattle, Washington, USA

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

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

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

[6]Department of Medicine, Box 356420, 98195, Seattle, Washington, USA

[7]Department of Global Health, University of Washington, Box 358116, 98195, Seattle, Washington, USA

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

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

[10]Department of Medicine, Box 356420, 98195, Seattle, Washington, USA

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

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

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

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

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

DOI  :  10.1186/1471-2334-11-307

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

来源: Springer

【 摘 要 】

BackgroundTrichomonas 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.MethodsWe 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.ResultsAmong 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).ConclusionDetection of vaginal HIV-1 RNA during ART was uncommon at visits before, during and after T. vaginalis infection.

【 授权许可】

CC BY   
© Masese et al; licensee BioMed Central Ltd. 2011