Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL.
Department of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA.
Sex Transm Dis. 2019 May;46(5):312-316. doi: 10.1097/OLQ.0000000000000968.
The optimal timing for nucleic acid amplification testing (NAAT) posttreatment for Trichomonas vaginalis has not been fully established. Testing too soon posttreatment may detect remnant nucleic acid that is not from viable organisms, falsely misclassifying person as infected. The purpose of this study was to examine how long T. vaginalis nucleic acid is detectable postmetronidazole (MTZ) treatment.
Women diagnosed with T. vaginalis treated with MTZ (2 g single-dose or 500 mg twice daily for 7 days multidose) self-collected a vaginal swab for NAAT at baseline and each week postcompletion of treatment through test of cure (TOC) at week 4, when a culture was also performed. Women who reported interim sexual exposure or who were culture positive at 4 weeks were excluded. Time to first negative NAAT was examined using Kaplan Meier analysis.
All women receiving multidose metronidazole were NAAT-negative by 21 days and those receiving single dose by 28 days postcompletion of treatment. Though over half (60.7%) of the cohort reinitiated sex during follow-up¸ all reported using condoms during sex or that they and their partner were treated before sex. Six (6.7%) of 89 had a positive NAAT following their first negative NAAT.
The optimal timing for T. vaginalis retesting after completion of treatment is 3 weeks for those receiving multidose MTZ and 4 weeks for those receiving single-dose, though sexual reexposure and false negatives should be considered.
尚未完全确定阴道毛滴虫治疗后进行核酸扩增检测（NAAT）的最佳时间。治疗后过早检测可能会检测到来自非存活生物的残留核酸，从而错误地将患者归类为感染。本研究旨在研究阴道毛滴虫治疗后多久可以检测到核酸。
诊断为阴道毛滴虫病的女性接受甲硝唑（2 g 单剂量或 500 mg 每日两次，共 7 天多剂量）治疗，在基线和治疗完成后每周（通过第 4 周的治愈测试 [TOC]）自我采集阴道拭子进行 NAAT，此时也进行培养。排除在第 4 周报告中途性接触或培养阳性的女性。使用 Kaplan-Meier 分析检查首次阴性 NAAT 的时间。
所有接受多剂量甲硝唑治疗的女性在治疗完成后 21 天内 NAAT 为阴性，接受单剂量治疗的女性在 28 天内为阴性。尽管超过一半（60.7%）的队列在随访期间重新开始性行为，但所有女性均报告在性行为中使用了避孕套，或者她们和她们的伴侣在性行为前接受了治疗。在首次阴性 NAAT 后，有 6 名（89 名中的 6.7%）女性的 NAAT 呈阳性。
对于接受多剂量 MTZ 治疗的患者，治疗完成后进行阴道毛滴虫再检测的最佳时间为 3 周，对于接受单剂量治疗的患者为 4 周，但应考虑性再暴露和假阴性的可能性。
