title: Trichomonas vaginalis is associated with pelvic inflammatory disease in women infected with human immunodeficiency virus.
abstract: We assessed the association between the causative agents of vaginal discharge and pelvic inflammatory disease (PID) among women attending a rural sexually transmitted disease clinic in South Africa; the role played by coinfection with human immunodeficiency virus type 1 (HIV-1) was studied. Vaginal and cervical specimens were obtained to detect Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, and bacterial vaginosis. HIV-1 infection was established by use of serum antibody tests. A total of 696 women with vaginal discharge were recruited, 119 of whom had clinical PID. Patients with trichomoniasis had a significantly higher risk of PID than did women without trichomoniasis (P=.03). PID was not associated with any of the other pathogens. When the patients were stratified according to HIV-1 status, the risk of PID in HIV-1-infected patients with T. vaginalis increased significantly (P=.002); no association was found in patients without HIV-1. T. vaginalis infection of the lower genital tract is associated with a clinical diagnosis of PID in HIV-1-infected women.
authors.affiliation: Africa Centre for Population Studies and Reproductive Health and Departments of Medical Microbiology, Durban, South Africa.
authors.forename: Prashini
authors.initials: P
authors.lastname: Moodley
authors.forename: David
authors.initials: D
authors.lastname: Wilkinson
authors.forename: Cathy
authors.initials: C
authors.lastname: Connolly
authors.forename: Jack
authors.initials: J
authors.lastname: Moodley
authors.forename: A Willem
authors.initials: AW
authors.lastname: Sturm
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000469:parasitology; D000328:Adult; D000818:Animals; D005260:Female; D015658:HIV Infections / Q000150:complications*; D015497:HIV-1; D006801:Humans; D000292:Pelvic Inflammatory Disease / Q000150:complications / Q000469:parasitology*; D012749:Sexually Transmitted Diseases / Q000469:parasitology; D014245:Trichomonas Infections / Q000150:complications* / Q000469:parasitology; D014246:Trichomonas vaginalis