Wang C C, McClelland R S, Reilly M, Overbaugh J, Emery S R, Mandaliya K, Chohan B, Ndinya-Achola J, Bwayo J, Kreiss J K
Departments of Medicine and Epidemiology, Division of Infectious Diseases, University of Washington, Seattle, WA 98104-2499, USA.
J Infect Dis. 2001 Apr 1;183(7):1017-22. doi: 10.1086/319287. Epub 2001 Feb 28.
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.
为评估阴道感染治疗对1型人免疫缺陷病毒（HIV-1）无细胞病毒及HIV-1感染细胞阴道脱落的影响，我们对念珠菌性外阴阴道炎、滴虫性阴道炎和细菌性阴道病治疗前后的HIV-1血清阳性女性进行了检查。对于念珠菌感染（n = 98），阴道HIV-1 RNA从3.36 log(10)拷贝/拭子降至2.86 log(10)拷贝/拭子（P <.001），HIV-1 DNA的流行率也有所下降（从36%降至17%；优势比[OR]为2.8；95%置信区间[CI]为1.3 - 6.5）。对于滴虫性阴道炎（n = 55），HIV-1 RNA从3.67 log(10)拷贝/拭子降至3.05 log(10)拷贝/拭子（P <.001），但HIV-1 DNA的流行率保持不变（22% - 25%；OR为0.8；95% CI为0.3 - 2.2）。对于细菌性阴道病（n = 73），HIV-1 RNA的脱落（从3.11 log(10)拷贝/拭子降至2.90 log(10)拷贝/拭子；P = 0.14）和DNA的流行率（从21%升至23%；OR为0.8；95% CI为0.3 - 2.0）均未改变。治疗念珠菌和滴虫后，阴道HIV-1分别下降了3.2倍和4.2倍。这些数据表明，纳入这些常见感染诊断和治疗的HIV-1传播干预策略值得评估。
