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Clin Infect Dis. 2014 Sep 15;59(6):883-7. doi: 10.1093/cid/ciu401. Epub 2014 Jun 9.

The influence of ART on the treatment of Trichomonas vaginalis among HIV-infected women.

Author information

1
Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana.
2
Department of Medicine, Louisiana State University, New Orleans.
3
Department of Medicine, University of Mississippi Medical Center, Jackson.
4
Baylor College of Medicine, Houston, Texas.

Abstract

OBJECTIVE:

Among women who are human immunodeficiency virus positive (HIV+), both prevalent and persistent infections with Trichomonas vaginalis (TV) are common. TV has been shown to increase vaginal shedding of HIV, which may influence HIV sexual and perinatal transmission, making prevention important. In 1 cohort of HIV+ women in Kenya, antiretroviral therapy (ART) use, mostly nevirapine based, was associated with lower cure rates of TV for single-dose therapy. Our goal was to repeat this study in a US-based cohort of HIV+/TV+ women and compare outcomes to those with multidose therapy.

METHODS:

A secondary data analysis was performed on a multicentered cohort of HIV+/TV+ women who were randomized to single-dose (2 grams) or 7-day (500 mg twice daily) multidose metronidazole (MTZ) treatment. Test of cure visit, via culture, occurred 6-12 days after treatment completion. Information was collected on sex partner treatment and sexual exposures. Persistent TV infection rates were compared for women on ART at baseline vs not on ART.

RESULTS:

Of the 226 women included, those on ART had more treatment failures than women not on ART (24/146 [16.4%] vs 5/80 [6.3%]; P = .03). When stratified by treatment arm, more treatment failures were seen in the single-dose arm (17/73 [23.3%] vs 3/39 [7.7%]; P = .05) than in the multidose arm (7/73 [9.6%] vs 2/41 [4.8%]; P = .39).

CONCLUSIONS:

ART usage was associated with a higher TV persistent infection rate among those receiving the single-dose treatment, but not the multidose, providing more evidence that multidose should be the preferred treatment for HIV+ women.

KEYWORDS:

HIV; Trichomonas vaginalis; antiretroviral; metronidazole

PMID:
24917661
PMCID:
PMC4200043
DOI:
10.1093/cid/ciu401
[Indexed for MEDLINE]
Free PMC Article
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