From the Department of Obstetrics and Gynecology.
College of Medicine, Medical University of South Carolina, Charleston, SC.
Sex Transm Dis. 2020 May;47(5):332-337. doi: 10.1097/OLQ.0000000000001159.
Trichomonas vaginalis is a common treatable sexually transmitted infection among older women. Persistent T. vaginalis infection after treatment is common among women with human immunodeficiency virus (HIV). We sought to determine if HIV-negative women were as likely as women with HIV to have persistent T. vaginalis infection.
We performed a retrospective cohort study of women 45 years or older with T. vaginalis infection. We evaluated differences in persistent T. vaginalis infection according to HIV status using χ analysis. We performed regression analyses to describe factors associated with persistent and recurrent infection in older women.
Over a 10-year study period, we identified 282 women with T. vaginalis, 46 with HIV. Most women (240, 86%) were treated in accordance with 2015 Centers for Disease Control and Prevention Sexually Transmitted Diseases treatment guidelines. Half of the women (144, 53%) had a repeat T. vaginalis test 90 to 365 days after treatment, and one third had persistent infection (39/125, 31%). Persistent infection was similar between women with HIV and HIV-negative women treated according to Centers for Disease Control recommendations (17% vs 33%, P = 0.3). When adjusting for age and incidental diagnosis, tobacco use was associated with an increased risk of more than 1 or recurrent T. vaginalis infection during the study period (adjusted odds ratio, 2.8; 95% confidence interval, 1.5-4.9).
The HIV status did not affect persistent T. vaginalis infection in women 45 years or older. Given over one third of women have a positive test within a year after the recommended treatment, our data support repeat testing in women 45 years and older treated for T. vaginalis.
阴道毛滴虫病是老年女性中常见的可治疗的性传播感染。在 HIV 阳性女性中，阴道毛滴虫病治疗后持续感染较为常见。我们试图确定 HIV 阴性女性与 HIV 阳性女性相比，是否同样可能存在阴道毛滴虫病持续感染。
我们对 45 岁或以上患有阴道毛滴虫病的女性进行了回顾性队列研究。我们使用 χ 检验评估了 HIV 状态对阴道毛滴虫病持续感染的影响。我们进行了回归分析，以描述与老年女性阴道毛滴虫病持续和复发感染相关的因素。
在 10 年的研究期间，我们共发现了 282 例阴道毛滴虫病患者，其中 46 例 HIV 阳性。大多数女性（240 例，86%）均根据 2015 年美国疾病控制与预防中心性传播疾病治疗指南进行了治疗。一半的女性（144 例，53%）在治疗后 90 至 365 天进行了重复阴道毛滴虫病检测，三分之一（39/125，31%）存在持续感染。根据美国疾病控制与预防中心的建议，HIV 阳性和 HIV 阴性女性的持续感染情况相似（17%比 33%，P = 0.3）。在调整年龄和偶然诊断后，吸烟与研究期间阴道毛滴虫病超过 1 次或复发感染的风险增加相关（调整后的优势比，2.8；95%置信区间，1.5-4.9）。
HIV 状态并未影响 45 岁及以上女性阴道毛滴虫病的持续感染。鉴于三分之一以上的女性在推荐治疗后一年内检测呈阳性，我们的数据支持对阴道毛滴虫病治疗后 45 岁及以上女性进行重复检测。
