-
Views
-
Cite
Cite
Alys Adamski, Rebecca A. Clark, Leandro Mena, Harold Henderson, Judy Levison, Norine Schmidt, Hirut T. Gebrekristos, David H. Martin, Patricia Kissinger, The Influence of ART on the Treatment of Trichomonas vaginalis Among HIV-Infected Women, Clinical Infectious Diseases, Volume 59, Issue 6, 15 September 2014, Pages 883–887, https://doi.org/10.1093/cid/ciu401
Close - Share Icon Share
Women coinfected with human immunodeficiency virus (HIV) and Trichomonas vaginalis and who are treated with 2 grams metronidazole (MTZ) are more likely to have persistent infections if they are receiving antiretroviral therapy compared with similar women treated with multidose MTZ.
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.
