Trichomonas vaginalis treatment reduces vaginal HIV-1 shedding.
BACKGROUND
Vaginal HIV-1 shedding has been associated with Trichomonas vaginalis (TV) infection and could play a role in HIV transmission. The purpose of the study was to examine if effective TV treatment reduces the presence of vaginal HIV-1 RNA.


METHODS
TV+ women attending an HIV outpatient clinic in New Orleans, LA, who resolved infection (n = 58) and TV-negative controls (n = 92), matched on antiretroviral therapy (ART) were examined and interviewed at baseline, 1, and 3 months. TV status was tested by culture and the amount of cell free HIV-1 RNA in the vaginal fluids was determined by the Amplicor HIV-1 Monitor ultrasensitive assay.


RESULTS
: Most women (81.3%) were black and the mean age was 37.5 (SD 8.7). At baseline, 46.0% had plasma HIV-1 RNA >/=10,000 copies/mL, 26.4% had CD4<200 cells/muL, 54.7% were taking ART, and only 26.0% had detectable HIV-1 RNA in their vaginal fluids. TV-positive women who were effectively treated for TV were less likely to shed HIV vaginally at 3-months post-treatment compared to baseline (R.R. 0.34, 95% CI: 0.12-0.92, P = 0.03), whereas there was no change for TV-negative women.


CONCLUSIONS
This study provides additional support that reducing TV infection among HIV-positive women may have an impact on the prevention of HIV transmission. Reasons for the delayed treatment effect and the effect on cervical shedding need further investigation.
Kissinger
Patricia
P
Tulane University Health Sciences Center - School of Public Health and Tropical Medicine, New Orleans, Louisiana 70012, USA. kissing@tulane.edu
Amedee
Angela
A
Clark
Rebecca A
RA
Dumestre
Jeanne
J
Theall
Katherine P
KP
Myers
Leann
L
Hagensee
Michael E
ME
Farley
Thomas A
TA
Martin
David H
DH
D000328:Adult; D000818:Animals; D000981:Antiprotozoal Agents / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000821:virology; D015497:HIV-1 / Q000302:isolation & purification / Q000502:physiology*; D006801:Humans; D008795:Metronidazole / Q000627:therapeutic use*; D055820:New Orleans; D016896:Treatment Outcome; D014247:Trichomonas Vaginitis / Q000188:drug therapy* / Q000469:parasitology; D014246:Trichomonas vaginalis / Q000187:drug effects; D014621:Vagina / Q000821:virology*; D017201:Virus Shedding
D000981:Antiprotozoal Agents; D008795:Metronidazole