Observation of Probable Persistent, Undetected<i>Trichomonas vaginalis</i>Infection among HIV‐Positive Women

Gatski, Megan; Kissinger, Patricia

doi:10.1086/653443

Cited by 33 publications

(24 citation statements)

References 6 publications

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“…is is in agreement with the rates reported by other authors [13,14,54] for HIVinfected patients (18-36%), which are higher than for the noninfected population (5%-8%) [55,56]. Recurrence may be related to treatment failure due to antibiotic resistance, to improper treatment, or to reinfections [14,22,54,57].…”

Section: Discussionsupporting

confidence: 92%

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Genital Infections of HIV-Infected Women Assisted by a Specialized Service

Acquaro

Duarte²,

Souza³

2013

ISRN Infectious Diseases

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e present study aimed at analyzing the persistence/recurrence of genital infections and its associated factors in HIV-infected women. Fiy-eight women treated for chlamydial infection, trichomoniasis, vulvovaginal candidiasis, and/or bacterial vaginosis (BV) and who had specimens collected for cure control up to one year aer treatment were studied. Diagnoses were performed by the Gram staining method for cases of BV and candidiasis and by T. vaginalis culture and qualitative PCR for C. trachomatis. Antiretroviral therapy was used by 79.3% of patients, and 62.1% showed an undetectable HIV plasma load. e most frequent infection was BV with persistence/recurrence of 52.4%, which was associated with a longer time period between treatment and cure control ( ), postmenopausal period ( ), and having a steady partner ( ). Persistence/recurrence of vulvovaginal candidiasis was observed in 25%, trichomoniasis in 23.1%, and chlamydial infection in 10.5%. e latter was associated with inadequate treatment of the partner ( ). ere was a tendency to higher persistence/recurrence of BV ( ) and trichomoniasis ( ) among patients with low T CD4 + lymphocyte counts. e majority of women in the present study showed good HIV-infection control and a vulnerable sexual behavior, which stress the importance of maintaining gynecological followup.

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Section: Discussionsupporting

confidence: 92%

“…Gatski and Kissinger [57], however, showed recurrent T. vaginalis in patients without sexual reexposure, thus indicating a probable treatment failure with the agent persisting and later recurring, unrelated to sexual practices. Hence, treatment failure may be an important cause of recurrence.…”

Section: Discussionmentioning

confidence: 95%

Genital Infections of HIV-Infected Women Assisted by a Specialized Service

Acquaro

Duarte²,

Souza³

2013

ISRN Infectious Diseases

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“…Women who tested negative for TV at the TOC visit, or who did not complete a TOC visit, were scheduled for a follow-up visit at 3 months after enrolment. This visit was done to include women with possible persistent, undetected TV at the TOC visit 20 21…”

Section: Methodsmentioning

confidence: 99%

The influence of bacterial vaginosis on the response to Trichomonas vaginalis treatment among HIV-infected women

Gatski

Martín

Levison

et al. 2011

Sexually Transmitted Infections

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Objective Trichomonas vaginalis (TV) is common in HIV+ women, and host factors may play a role in TV treatment outcomes. The purpose of this study was to examine the influence of bacterial vaginosis (BV) on the response to TV treatment among HIV+ women. Methods A secondary analysis was conducted of a clinical trial which randomised HIV+/TV+ women to metronidazole (MTZ) treatment: 2 g (single-dose) versus 7 day 500 mg twice daily (multidose). BV was classified using Nugent scores from baseline Gram stains. Women were recultured for TV at test-of-cure (TOC) and again at 3 months if TV-negative at TOC. Repeat TV infection rates were compared for women with a baseline TV/BV coinfection versus baseline TV infection only, and stratified by treatment arm. Results Among 244 HIV+/TV+ women (mean age=40.3, ±9.5; 92.2% African–American), the rate of BV was 66.8%. Women with BV were more likely to report douching and ≥1 recent sex partners. HIV+ women with baseline TV/BV coinfection were more likely to be TV-positive at TOC than women with baseline TV infection only (RR 2.42 (95% CI 0.96 to 6.07; p=0.05)). When stratified by treatment arm, the association was only found in the single-dose arm (p=0.02) and not in the multidose arm (p=0.92). This interaction did not persist at 3 months. Conclusions For HIV+/TV+ women, the rate of BV was high, and BV was associated with early failure of the MTZ single-dose treatment for TV. Biological explanations require further investigation.

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“…This infection is associated with poor health outcomes for women, including vaginitis, preterm delivery, low-birth-weight infants, infertility, susceptibility to human papillomavirus (HPV) and herpesvirus infection, and cervical cancer (36). As there is no immunity to T. vaginalis, a common trait of trichomonosis is persistence (29). In males, T. vaginalis infection is usually asymptomatic, although in some cases, urethritis and chronic prostatitis are observed (7,28).…”

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confidence: 99%

Comparative Transcriptomic and Proteomic Analyses of Trichomonas vaginalis following Adherence to Fibronectin

Huang

et al. 2012

Infect Immun

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FN-binding protein), and stress-related proteins were upregulated in the FN-adherent cells. Stress-related genes and proteins were highly expressed in both the transcriptome and proteome of FN-bound organisms, implying that these genes and proteins may play critical roles in the response to adherence. This is the first report of a comparative proteomic and transcriptomic analysis after the binding of T. vaginalis to FN. This approach may lead to the discovery of novel virulence genes and affirm the role of genes involved in disease pathogenesis. This knowledge will permit a greater understanding of the complex host-parasite interplay.

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Observation of Probable Persistent, UndetectedTrichomonas vaginalisInfection among HIV‐Positive Women

Cited by 33 publications

References 6 publications

Genital Infections of HIV-Infected Women Assisted by a Specialized Service

Genital Infections of HIV-Infected Women Assisted by a Specialized Service

The influence of bacterial vaginosis on the response to Trichomonas vaginalis treatment among HIV-infected women

Comparative Transcriptomic and Proteomic Analyses of Trichomonas vaginalis following Adherence to Fibronectin

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