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Infectious disease

New Trichs: screening and therapy

Nature Reviews Urology volume 11, page 427 (2014)Cite this article

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Trichomonas vaginalis is estimated to be the most common nonviral sexually transmitted infection (STI) worldwide, but the actual prevalence is not known as no national screening and surveillance programmes are available. However, screening and subsequent treatment of T. vaginalis is important, particularly in patients with HIV, as this protozoan parasite might be associated with increased transmission of the HIV virus. Two papers now published in the journal Clinical Infectious Diseases add insight into these important aspects of the management of T. vaginalis infection, which might ultimately enable better disease control.

In the first paper, Muzny et al. report a comparison of the most common T. vaginalis screening assay, wet mount microscopy of vaginal fluid, with highly sensitive nucleic acid amplification testing (NAAT) in women presenting to a sexual health clinic in the USA. Of the 3,821 women who underwent NAAT testing, 27.0% were positive for T. vaginalis infection compared with 19.6% of the 3,765 women who also underwent wet mount microscopy (P <0.001). Of the 317 discordant results, most were attributable to false negatives by wet mount microscopy (n = 301), rather than false positives. Importantly, women with false negative microscopy findings were generally less likely to have urological symptoms, elevated vaginal pH and leukorrhea, suggesting that such patients should be evaluated using NAAT.

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References

  1. Muzny, C. A. et al. Added benefit of nucleic acid amplification testing for the diagnosis of Trichomonas vaginalis among men and women attending a sexually transmitted disease clinic. Clin. Infect. Dis. 10.1093/cid/ciu446

  2. Adamski, A. et al. The influence of ART on the treatment of Trichomonas vaginalis among HIV-infected women. Clin. Infect. Dis. 10.1093/cid/ciu401

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Authors
  1. David Killock
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Killock, D. New Trichs: screening and therapy. Nat Rev Urol 11, 427 (2014). https://doi.org/10.1038/nrurol.2014.158

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