The effect of treatment of vaginal infections on shedding of human immunodeficiency virus type 1

To assess the effect of treatment of vaginal infections on vaginal shedding of cell-free human immunode®ciency virus type 1 (HIV-1) and HIV-1±infected cells, HIV-1±seropositive women were examined before and after treatment of Candida vulvovaginitis, Trichomonas vaginitis, and bacterial vaginosis. For Candida (), vaginal HIV-1 RNA decreased from 3.36 ton p 98 2.86 log10 copies/swab (), as did the prevalence of HIV-1 DNA (36 % to 17%; oddsP!.001 ratio [OR], 2.8; 95 % con®dence interval [CI], 1.3±6.5). For Trichomonas vaginitis (),n p 55 HIV-1 RNA decreased from 3.67 to 3.05 log10 copies/swab (), but the prevalence ofP!.001 HIV-1 DNA remained unchanged (22%±25%; OR, 0.8; 95 % CI, 0.3±2.2). For bacterial vagi-nosis (), neither the shedding of HIV-1 RNA (from 3.11 to 2.90 log10 copies/swab;n p 73) nor the prevalence of DNA (from 21 % to 23%; OR, 0.8; 95 % CI, 0.3±2.0) changed.P p.14 Vaginal HIV-1 decreased 3.2- and 4.2-fold after treating Candida and Trichomonas, respectively. These data suggest that HIV-1 transmission intervention strategies that incorporate diagnosis and treatment of these prevalent infections warrant evaluation. Important contributions to the understanding of the associ-ation between sexually transmitted diseases (STDs) and the trans-mission of human immunode®ciency virus type 1 (HIV-1) hav