The effect of treatment of vaginal infections on shedding of human immunodeficiency virus type 1.

Abstract

To assess the effect of treatment of vaginal infections on vaginal shedding of cell-free human immunodeficiency virus type 1 (HIV-1) and HIV-1-infected cells, HIV-1-seropositive women were examined before and after treatment of Candida vulvovaginitis, Trichomonas vaginitis, and bacterial vaginosis. For Candida (n=98), vaginal HIV-1 RNA decreased from 3.36 to 2.86 log(10) copies/swab (P<.001), as did the prevalence of HIV-1 DNA (36% to 17%; odds ratio [OR], 2.8; 95% confidence interval [CI], 1.3-6.5). For Trichomonas vaginitis (n=55), HIV-1 RNA decreased from 3.67 to 3.05 log(10) copies/swab (P<.001), but the prevalence of HIV-1 DNA remained unchanged (22%-25%; OR, 0.8; 95% CI, 0.3-2.2). For bacterial vaginosis (n=73), neither the shedding of HIV-1 RNA (from 3.11 to 2.90 log(10) copies/swab; P=.14) nor the prevalence of DNA (from 21% to 23%; OR, 0.8; 95% CI, 0.3-2.0) changed. Vaginal HIV-1 decreased 3.2- and 4.2-fold after treating Candida and Trichomonas, respectively. These data suggest that HIV-1 transmission intervention strategies that incorporate diagnosis and treatment of these prevalent infections warrant evaluation.

• Authors: C C Wang, R S McClelland, M Reilly, J Overbaugh, S R Emery, K Mandaliya, B Chohan, J Ndinya-Achola, J Bwayo, J K Kreiss
• Journal: The Journal of infectious diseases (J Infect Dis) Vol. 183 Issue 7 Pg. 1017-22 (Apr 01 2001) ISSN: 0022-1899 [Print] United States
• PMID: 11237825 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Anti-Bacterial Agents
• Antitrichomonal Agents
• DNA, Viral
• RNA, Viral
• Nystatin
• Metronidazole

Topics

• Adult
• Anti-Bacterial Agents (therapeutic use)
• Antitrichomonal Agents (therapeutic use)
• Candidiasis (complications, drug therapy)
• DNA, Viral (analysis)
• Down-Regulation
• Female
• HIV Infections (complications, transmission, virology)
• HIV Seropositivity (complications, virology)
• HIV-1 (genetics, isolation & purification)
• Humans
• Metronidazole (therapeutic use)
• Nystatin (therapeutic use)
• Odds Ratio
• Prospective Studies
• RNA, Viral (analysis)
• Trichomonas Vaginitis (complications, drug therapy)
• Vagina (pathology, virology)
• Vaginitis (complications, drug therapy, microbiology)
• Vaginosis, Bacterial (complications, drug therapy)
• Virus Shedding (drug effects)