原创力文档a prospective study of vaginal trichomoniasis and hiv-1 shedding in women on antiretroviral therapy一个前瞻性研究女性阴道滴虫病和hiv - 1脱落的抗逆转录病毒治疗.pdfVIP
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a prospective study of vaginal trichomoniasis and hiv-1 shedding in women on antiretroviral therapy一个前瞻性研究女性阴道滴虫病和hiv - 1脱落的抗逆转录病毒治疗
Masese et al. BMC Infectious Diseases 2011, 11:307
/1471-2334/11/307
RESEARCH ARTICLE Open Access
A prospective study of vaginal trichomoniasis and
HIV-1 shedding in women on antiretroviral therapy
1* 2,5,6 5 6 5 5
Linnet N Masese , Susan M Graham , Ruth Gitau , Nobert Peshu , Walter Jaoko , Jeckoniah O Ndinya-Achola ,
Kishorchandra Mandaliya7, Barbra A Richardson4,8, Julie Overbaugh8 and R Scott McClelland1,2,3,5
Abstract
Background: Trichomonas 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.
Methods: We 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.
Results: Among 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% -
3
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