From the John W. Deming Department of Medicine, Tulane University School of Medicine, New Orleans, LA.
Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA.
Sex Transm Dis. 2024 Jan 1;51(1):61-64. doi: 10.1097/OLQ.0000000000001891. Epub 2023 Oct 30.
Trichomonas vaginalis (TV) is a common sexually transmitted infection. High rates of repeated infections have been observed, particularly among women living with human immunodeficiency virus (HIV). Trichomonas vaginalis frequently cooccurs with bacterial vaginosis (BV). The purpose of this study was to determine if coinfections with TV, BV, and HIV could lead to differential treatment failure outcomes.
Data were pooled from 2 prior randomized control trials comparing 2 g oral single-dose versus 500-mg twice daily oral 7-day dose metronidazole for the treatment of TV in HIV infected and HIV uninfected women. Trichomonas vaginalis rates 1-month postcompletion of treatment were compared by arm, HIV and BV status after removing those who had sexual reexposure, and/or did not complete their treatment.
Data for 795 subjects were included in the study, of which 76 (9.6%) experienced treatment failure. In the final multivariable model, which included treatment dose, HIV status, and BV status, odds of treatment failure infection in the 7-day dose group were lower than the odds in the single dose group (odds ratio, 040; 95% confidence interval, 0.23-0.68). Treatment failure was lower in the multidose arm compared with single dose for both HIV-infected (4.0% vs 10.3%; P = 0.0568) and HIV-uninfected (7.3% vs 15.4%; P = 0.0037). Neither HIV nor BV was associated with higher treatment failure.
Human immunodeficiency virus infection and BV status did not significantly alter the rate of repeat infection for either single dose or 7-day dose metronidazole. Among all women, 7-day metronidazole lowered the odds of treatment failure.
阴道毛滴虫（TV）是一种常见的性传播感染。尤其是在人类免疫缺陷病毒（HIV）感染者中，观察到重复感染率很高。阴道毛滴虫常与细菌性阴道病（BV）共存。本研究旨在确定 TV、BV 和 HIV 合并感染是否会导致治疗失败的结果不同。
本研究数据来自两项比较 2g 口服单剂量与 500mg 口服 7 天 2 次剂量甲硝唑治疗 HIV 感染者和 HIV 未感染者阴道毛滴虫的随机对照试验。比较了治疗完成后 1 个月时各组的 TV 感染率，去除了那些有性再暴露和/或未完成治疗的患者后，根据治疗组、HIV 状态和 BV 状态进行比较。
本研究纳入了 795 名患者的数据，其中 76 名（9.6%）发生了治疗失败。在最终的多变量模型中，包括治疗剂量、HIV 状态和 BV 状态，7 天剂量组的治疗失败感染几率低于单剂量组（比值比，0.40；95%置信区间，0.23-0.68）。与单剂量相比，多剂量组在 HIV 感染者（4.0%对 10.3%；P = 0.0568）和 HIV 未感染者（7.3%对 15.4%；P = 0.0037）中，治疗失败的发生率均较低。HIV 和 BV 均与治疗失败率升高无关。
HIV 感染和 BV 状态并未显著改变单剂量或 7 天剂量甲硝唑治疗的重复感染率。在所有女性中，7 天甲硝唑降低了治疗失败的几率。
