The effect of treatment of vaginal infections on shedding of human immunodeficiency virus type 1.
To assess the effect of treatment of vaginal infections on vaginal shedding of cell-free human immunodeficiency virus type 1 (HIV-1) and HIV-1-infected cells, HIV-1-seropositive women were examined before and after treatment of Candida vulvovaginitis, Trichomonas vaginitis, and bacterial vaginosis. For Candida (n=98), vaginal HIV-1 RNA decreased from 3.36 to 2.86 log(10) copies/swab (P<.001), as did the prevalence of HIV-1 DNA (36% to 17%; odds ratio [OR], 2.8; 95% confidence interval [CI], 1.3-6.5). For Trichomonas vaginitis (n=55), HIV-1 RNA decreased from 3.67 to 3.05 log(10) copies/swab (P<.001), but the prevalence of HIV-1 DNA remained unchanged (22%-25%; OR, 0.8; 95% CI, 0.3-2.2). For bacterial vaginosis (n=73), neither the shedding of HIV-1 RNA (from 3.11 to 2.90 log(10) copies/swab; P=.14) nor the prevalence of DNA (from 21% to 23%; OR, 0.8; 95% CI, 0.3-2.0) changed. Vaginal HIV-1 decreased 3.2- and 4.2-fold after treating Candida and Trichomonas, respectively. These data suggest that HIV-1 transmission intervention strategies that incorporate diagnosis and treatment of these prevalent infections warrant evaluation.
Wang
C C
CC
Departments of Medicine and Epidemiology, Division of Infectious Diseases, University of Washington, Seattle, WA 98104-2499, USA. chiaw@u.washington.edu
McClelland
R S
RS
Reilly
M
M
Overbaugh
J
J
Emery
S R
SR
Mandaliya
K
K
Chohan
B
B
Ndinya-Achola
J
J
Bwayo
J
J
Kreiss
J K
JK
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000994:Antitrichomonal Agents / Q000627:therapeutic use*; D002177:Candidiasis / Q000150:complications / Q000188:drug therapy; D004279:DNA, Viral / Q000032:analysis; D015536:Down-Regulation; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000635:transmission / Q000821:virology*; D006679:HIV Seropositivity / Q000150:complications / Q000821:virology*; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008795:Metronidazole / Q000627:therapeutic use; D009761:Nystatin / Q000627:therapeutic use; D016017:Odds Ratio; D011446:Prospective Studies; D012367:RNA, Viral / Q000032:analysis; D014247:Trichomonas Vaginitis / Q000150:complications / Q000188:drug therapy; D014621:Vagina / Q000473:pathology / Q000821:virology*; D014627:Vaginitis / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D016585:Vaginosis, Bacterial / Q000150:complications / Q000188:drug therapy; D017201:Virus Shedding / Q000187:drug effects*
D000900:Anti-Bacterial Agents; D000994:Antitrichomonal Agents; D004279:DNA, Viral; D012367:RNA, Viral; D009761:Nystatin; D008795:Metronidazole