Trichomonas Vaginalis Treatment Reduces Vaginal HIV-1 Shedding

The researchers wrote that vaginal HIV-1 shedding has been associated with Trichomonas vaginalis (TV) infection and may play a role in HIV transmission. The study's purpose was to determine if effective TV treatment reduces the presence of vaginal HIV-1 RNA.

Fifty-eight women attending an HIV outpatient clinic with resolved TV infection and 92 TV-negative controls who were matched on antiretroviral therapy (ART) were evaluated and interviewed at baseline, one and three months. Most women (81.3 percent) were black; the mean age was 37.5. Their TV status was determined via culture, and the amount of cell-free HIV-1 RNA present in vaginal fluids was determined using the Amplicor HIV-1 Monitor ultrasensitive assay.

At baseline, 46 percent had plasma HIV-1 RNA >10,000 copies/mL; 26.4 percent had CD4<200 cells/?L; 54.7 percent were taking ART; and only 26 percent had detectable HIV-1 RNA in their vaginal fluids. TV-positive women who were treated effectively for TV were less likely to shed HIV vaginally at three months after treatment compared to baseline (RR 0.34, 95 percent CI: 0.12-.0.92, P=0.03). There was no change for TV-negative women.

"This study provides additional support that reducing TV infection among HIV-positive women may have an impact on the prevention of HIV transmission," the authors concluded. "Reasons for the delayed treatment effect and the effect on cervical shedding need further investigation."

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