title: Trichomonas vaginalis treatment reduces vaginal HIV-1 shedding.
abstract: 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.
authors.affiliation: Tulane University Health Sciences Center - School of Public Health and Tropical Medicine, New Orleans, Louisiana 70012, USA. kissing@tulane.edu
authors.forename: Patricia
authors.initials: P
authors.lastname: Kissinger
authors.forename: Angela
authors.initials: A
authors.lastname: Amedee
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Clark
authors.forename: Jeanne
authors.initials: J
authors.lastname: Dumestre
authors.forename: Katherine P
authors.initials: KP
authors.lastname: Theall
authors.forename: Leann
authors.initials: L
authors.lastname: Myers
authors.forename: Michael E
authors.initials: ME
authors.lastname: Hagensee
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Farley
authors.forename: David H
authors.initials: DH
authors.lastname: Martin
mesh_terms: 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
chemical_list: D000981:Antiprotozoal Agents; D008795:Metronidazole