Muzny Christina A, Tamhane Ashutosh R, Eaton Ellen F, Hudak Kathryn, Burkholder Greer A, Schwebke Jane R
1 Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA.
2 University of Alabama School of Medicine, Birmingham, AL, USA.
Int J STD AIDS. 2019 Mar;30(4):344-352. doi: 10.1177/0956462418807115. Epub 2018 Nov 28.
Trichomonas vaginalis infection contributes to HIV transmission. The study objective was to determine the incidence and predictors of T. vaginalis reinfection among HIV-infected women in Birmingham, Alabama. A retrospective cohort study of women at an urban HIV clinic from August 2014 to March 2016 with T. vaginalis by nucleic acid amplification test (NAAT) was conducted. Time to first episode of reinfection was evaluated using Kaplan-Meier survival curves. The association of various predictors was evaluated by univariate and multivariable Cox proportional hazards analyses. Of 612 HIV-infected women at the UAB HIV clinic tested for T. vaginalis by the Aptima TV assay, 110 (18.0%) were identified with prevalent T. vaginalis infection. Overall, 25/110 (22.7%) had a first episode of T. vaginalis reinfection by NAAT with a rate of 3.7 reinfections per 100 person-months (95% confidence interval [CI]: 2.3, 5.2). In univariate analysis, only an HIV viral load (VL) ≥200 copies/ml approached statistical significance (hazard ratio = 2.26; 95% CI: 0.97, 5.29, p = 0.06). After adjusting for age and race, the association of HIV VL ≥200 copies/ml remained strong (adjusted hazard ratio = 2.49; 95% CI: 0.99, 6.27, p = 0.05). T. vaginalis reinfection was high among HIV-infected women in this sample, necessitating enhanced disease control efforts in this high-risk population.
阴道毛滴虫感染会促进艾滋病毒传播。本研究的目的是确定阿拉巴马州伯明翰市感染艾滋病毒女性中阴道毛滴虫再感染的发生率及预测因素。对2014年8月至2016年3月在一家城市艾滋病毒诊所通过核酸扩增试验（NAAT）检测出阴道毛滴虫的女性进行了一项回顾性队列研究。使用Kaplan-Meier生存曲线评估首次再感染发作的时间。通过单变量和多变量Cox比例风险分析评估各种预测因素的关联。在UAB艾滋病毒诊所通过Aptima TV检测法检测阴道毛滴虫的612名感染艾滋病毒的女性中，110名（18.0%）被确定为患有现患阴道毛滴虫感染。总体而言，25/110（22.7%）通过NAAT首次出现阴道毛滴虫再感染，再感染率为每100人月3.7次（95%置信区间[CI]：2.3，5.2）。在单变量分析中，只有艾滋病毒病毒载量（VL）≥200拷贝/ml接近统计学显著性（风险比=2.26；95%CI：0.97，5.29，p=0.06）。在对年龄和种族进行调整后，艾滋病毒VL≥200拷贝/ml的关联仍然很强（调整后风险比=2.49；95%CI：0.99，6.27，p=0.05）。在该样本中，感染艾滋病毒的女性中阴道毛滴虫再感染率很高，因此有必要在此高危人群中加强疾病控制措施。
