de Brum Vieira Patricia, Tasca Tiana, Secor W Evan
Programa de Pos-graduacao em Ciencias Biologicas, Universidade Federal do Pampa, 97300-000, Sao Gabriel, RS, Brazil.
Faculdade de Farmacia, Universidade Federal do Rio Grande do Sul, 90610-000, Porto Alegre, RS, Brazil.
Curr Top Med Chem. 2017;17(11):1249-1265. doi: 10.2174/1568026616666160930150429.
Trichomoniasis is a sexually transmitted disease (STD) caused by infection with the protozoan parasite Trichomonas vaginalis. It is considered the most prevalent non-viral sexually transmitted disease worldwide. Recently, the infection has been associated with adverse outcomes of pregnancy and increased risks of HIV acquisition and transmission, as well as an association with cervical and prostate cancers. The consequences of trichomoniasis are likely much greater than previously recognized, both at the individual and the community level. Since many cases are asymptomatic, and the most common approach used for diagnosis (wet mount) is also one of the least sensitive, millions of T. vaginalis infections remain undiagnosed and therefore untreated. The purpose of this review is to address what is known about the treatment of T. vaginalis infections and what additional approaches could be pursued. The increasing recognition of the potential public health implications of trichomoniasis has resulted in greater attention to improving effectiveness of the interventions for affected individuals. Currently, treatment relies almost solely on one class of drugs, the 5- nitroimidazoles, which causes concern should widespread drug resistance arise. There are also concerns regarding which 5-nitroimidazole to use as not all of them are active against T. vaginalis. Finally, new therapeutic targets and active compounds with treatment potential are considered.
滴虫病是一种由原生动物寄生虫阴道毛滴虫感染引起的性传播疾病（STD）。它被认为是全球最普遍的非病毒性传播疾病。最近，该感染与妊娠不良结局、感染和传播HIV的风险增加以及与宫颈癌和前列腺癌的关联有关。滴虫病的后果在个体和社区层面可能比以前认识到的要严重得多。由于许多病例无症状，且最常用的诊断方法（湿涂片）也是最不敏感的方法之一，数百万例阴道毛滴虫感染仍未被诊断出来，因此未得到治疗。本综述的目的是阐述关于阴道毛滴虫感染治疗的已知情况以及可以采用哪些其他方法。对滴虫病潜在公共卫生影响的认识不断提高，使得人们更加关注提高针对受影响个体的干预措施的有效性。目前，治疗几乎完全依赖于一类药物，即5-硝基咪唑类药物，如果出现广泛的耐药性，这会引起担忧。对于使用哪种5-硝基咪唑也存在担忧，因为并非所有此类药物都对阴道毛滴虫有活性。最后，还考虑了具有治疗潜力的新治疗靶点和活性化合物。
