The Role of Bacterial Vaginosis and Trichomonas in HIV Transmission Across The Female Genital Tract

Mirmonsef, Paria; Krass, Laurie; Landay, Alan; Spear, Gregory T.

doi:10.2174/157016212800618165

Cited by 88 publications

(68 citation statements)

References 75 publications

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“…The vaginal microbiota is composed predominantly of various lactobacilli which produce lactic acid and also hydrogen peroxide to outcompete pathogenic organisms and maintain vaginal health. When the type and relative proportion of bacteria are altered in lower genital tract, bacterial vaginosis results, where the chief microbiota shifts from lactobacilli to Gardnerella, Clostridiales, Mycoplasma, and Prevotella [8].…”

Section: Bacterial Vaginosis and Hivmentioning

confidence: 99%

“…The possible mechanism by which bacterial vaginosis might affect HIV acquisition and transmission is by inducing a pro-inflammatory environment, consisting of cytokines and toll-like receptor (TLR) ligands, which is conducive to HIV propagation [8].…”

Section: Bacterial Vaginosis and Hivmentioning

confidence: 99%

“…Trichomonas vaginalis increases susceptibility to HIV infection by causing epithelial barrier disruption and by changes in innate and adaptive immunity in the female genital tract [8]. Table 2 LGTI with respect to CD4 cell counts in HIV-seropositive women The present study also reported increase in prevalence of candidiasis in HIV-seropositive women, which was 43.2 % as compared to 18 % in the HIV-uninfected women of reproductive age group, and like other LGTI, risk of candidial vaginal colonization increases with lower CD4 cell counts [3,7].…”

Section: Trichomoniasis and Hivmentioning

confidence: 99%

See 2 more Smart Citations

Lower Genital Tract Infections in HIV-Infected Women: Can We Afford to Miss?

Lallar¹,

Nanda

Nandal

2014

J Obstet Gynecol India

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Objectives To study prevalence of lower genital tract infections (LGTI) (bacterial vaginosis, trichomoniasis, and candidiasis) in HIV-seropositive women and correlation with CD4 counts and antiretroviral therapy (ART). Methods Cross-sectional study conducted in 200 HIV-1-seropositive women (18 to 45 years) attending ART clinic of PGIMS, Rohtak. Vaginal samples sent for laboratory diagnosis of bacterial vaginosis, trichomoniasis, and candidiasis, CD4 count determined and data analyzed using Chi-square method. Results Prevalence of bacterial vaginosis, candidiasis, and trichomoniasis was 47.7, 43.2, and 8.8 % respectively, 30 % women with CD4 counts \200 cells/ll had LGTI, and 17.4 % women with CD4 [200 Cell/ll had LGTI. Of 70 women not on ART, 18.6 % had LGTI and 30 of 130 on ART had LGTI. Conclusions HIV-seropositive women had higher prevalence of LGTI especially at lower CD4 counts and women on ART did not have a lower prevalence of LGTI and should be screened for LGTI to decrease HIV transmission.

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Section: Bacterial Vaginosis and Hivmentioning

confidence: 99%

Section: Bacterial Vaginosis and Hivmentioning

confidence: 99%

Section: Trichomoniasis and Hivmentioning

confidence: 99%

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Lower Genital Tract Infections in HIV-Infected Women: Can We Afford to Miss?

Lallar¹,

Nanda

Nandal

2014

J Obstet Gynecol India

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“…Lactobacilli also act against pathogenic organisms in the vaginal environment, by out-competing them for nutrients, and also via the release of hydrogen peroxide, which is toxic to a number of potentially BV causing organisms such as Gardnerella vaginalis (Klebanoff et al, 1991). BV can have serious health implications, many of which overlap with trichomoniasis; increased risk of HIV transmission (Mirmonsef et al, 2012), ascending inflammatory infections and preterm birth/low birth weight pregnancy (Taylor et al, 2013). The combination of T.…”

Section: Relationship With Other Microorganismsmentioning

confidence: 99%

Trichomonas vaginalis: Clinical relevance, pathogenicity and diagnosis

Edwards

Burke

Smalley

et al. 2014

Critical Reviews in Microbiology

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Trichomonas vaginalis is the etiological agent of trichomoniasis, the most prevalent non-viral sexually transmitted disease worldwide. Trichomoniasis is a widespread, global health concern, and occurring at an increasing rate. Infections of the female genital tract can cause a range of symptoms, including vaginitis and cervicitis, whilst infections in males are generally asymptomatic. The relatively mild symptoms, and lack of evidence for any serious sequelae, have historically led to this disease being under diagnosed, and under researched. However, growing evidence that T. vaginalis infection is associated with disease states with high morbidity in both men and women has increased the efforts to diagnose and treat patients harbouring this parasite. The pathology of trichomoniasis results from damage to the host epithelia, caused by a variety of processes during infection, and recent work has highlighted the complex interactions between the parasite and host, commensal microbiome, and accompanying symbionts. The commercial release of a number of nucleic acid amplification tests (NAATs) has added to the available diagnostic options. Immunoassay based Point of Care testing is currently available, and a recent initial evaluation of a NAAT Point of Care system has given promising results, which would enable testing and treatment in a single visit.

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“…51 Increased risks of acquiring and transmitting STIs such as HIV have been shown to be associated with decreased Lactobacillus species in the vaginal microbiota. [64][65][66] The interactions of vaginal microbiota and C. trachomatis were recently studied by analyzing the effects of Lactobacillus strains (L. brevis and L. salivarius) on the different phases of C. trachomatis developmental cycle. Lactobacilli had an adverse effect on chlamydial elementary bodies, on chlamydial adsorption to epithelial cells, and on intracellular phases of chlamydial replication.…”

mentioning

confidence: 99%

Development of a vaccine for Chlamydia trachomatis: challenges and current progress

Hafner¹

2015

VDT

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Abstract:Chlamydia trachomatis remains an enigmatic bacterial pathogen with no vaccine yet available to treat human ocular and genital tract infections caused by tissue-tropic serovars of the organism. Globally, it is the leading cause of preventable blindness as well as the leading cause of bacterial sexually transmitted infections. The pathogen has a range of virulence factors that enable it to successfully evade both the innate and adaptive immune system of the host. The host immune system, although protective, paradoxically is also associated closely with the pathologies of trachoma and pelvic inflammatory disease -disease sequelae of some chlamydial infections and reinfections in some genetically susceptible hosts. In this review, we focus on what is known currently about the pathogenesis of ocular and genital infections caused by this mucosal pathogen. We also discuss novel insights into the pathogenesis of infections caused by the genital and ocular serovars of C. trachomatis, including a discussion of both pathogen and host factors, such as the human microbiota at these mucosal sites as well as the current immunological challenges facing vaccine development. Finally, we discuss the current progress toward development of a vaccine against C. trachomatis. A wide range of recombinant protein antigens are being identified and, hence, are available for vaccine trials. A plasmid-free live strain has recently been produced and evaluated in the mouse (Chlamydia muridarum) and monkey (C. trachomatis) models. The data for ocular infections in the monkey model was particularly encouraging, although the path to regulatory approval of a live vaccine is still uncertain. While still a major challenge, vaccines for ocular and genital C. trachomatis infections are looking more promising.

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The Role of Bacterial Vaginosis and Trichomonas in HIV Transmission Across The Female Genital Tract

Cited by 88 publications

References 75 publications

Lower Genital Tract Infections in HIV-Infected Women: Can We Afford to Miss?

Lower Genital Tract Infections in HIV-Infected Women: Can We Afford to Miss?

Trichomonas vaginalis: Clinical relevance, pathogenicity and diagnosis

Development of a vaccine for Chlamydia trachomatis: challenges and current progress

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