Trichomonas vaginalis and HIV infection acquisition: a systematic review and meta-analysis

Abstract

ObjectivesTrichomoniasis is the most prevalent curable STI globally, with the highest incidence and prevalence in sub-Saharan Africa (sSA). STIs have largely been associated with an increase in HIV acquisition. Our objective was to assess the existing literature available in English regarding the association of Trichomoniasis and HIV-1 acquisition.MethodsThe review protocol was registered at the International Prospective Register of Systematic Reviews (PROSPERO) under number CRD42018082702. We searched MEDLINE, Embase and Scopus databases to collect articles measuring the association of Trichomonas vaginalis infection and HIV acquisition and performed a meta-analysis and qualitative synthesis of the literature.ResultsWe identified 1806 unduplicated citations, of which 18 papers and 1 conference abstract were eligible for inclusion in the review after applying our inclusion and exclusion criteria. All the studies included in the systematic review had been carried out in sSA. The articles reported various measures of effects, namely: HRs, rate ratios, risk ratios and ORs. In a meta-analysis restricted to 11 studies reporting HR, individuals infected with T. vaginalis were 1.5 times more likely to acquire HIV compared with individuals not infected with T. vaginalis (95% CI 1.3 to 1.7; p<0.001).ConclusionsT. vaginalis is an important factor in HIV acquisition especially in sSA where the prevalence of both T. vaginalis and HIV-1 are high. This systematic review and meta-analysis confirms the evidence that infection with T. vaginalis augments HIV acquisition with 50%. Diagnosis and treatment of T. vaginalis infection in both high-risk and low-risk individuals may be a potential tool to reduce new HIV infections.Trial registration numberCRD42018082702

Characterizing the Fused TvG6PD::6PGL Protein from the Protozoan Trichomonas vaginalis, and Effects of the NADP+ Molecule on Enzyme Stability

“…In women, this pathogen adheres to and damages vaginal epithelial cells and causes urethritis, vaginitis, and cervicitis [1], causing symptoms ranging from a relatively asymptomatic state to severe inflammation [7]. In addition, infected women have several complications associated with unfavorable pregnancy outcomes, such as premature delivery, low birth weight [8], a greater risk of HIV transmission and/or acquisition [9], and cervical cancer [10]. In men, the symptoms and prevalence of trichomoniasis are less well characterized, but the infection appears to be asymptomatic in 70% of male cases [11].…”

Prevalence and factors associated with Trichomonas vaginalis infection among men who have sex with men and female sex workers in Togo, 2017.

“…[10][11][12][13]. In a meta-analysis of 11 studies, T. vaginalis infection was a risk factor for HIV (95% CI 1.3 to 1.7; p < 0.001) [14]. Data on T. vaginalis are mainly described in pregnant women [15,16] and few data are available on key populations as populations with high risk of HIV infection.…”

Identification of the NADH-oxidase gene in Trichomonas vaginalis

“…The parasite colonizes the urogenital tract and causes urethritis, vaginitis and cervicitis. Moreover, T. vaginalis can cause adverse pregnancy outcomes (Silver et al, 2014) and facilitates infection with HIV (Masha et al, 2019). Due to its anaerobic metabolism, T. vaginalis has to effectively remove intracellular oxygen in order to prevent the deactivation of essential enzymes such as pyruvate:ferredoxin oxidoreductase (PFOR) and hydrogenase (Lloyd and Kristensen, 1985).…”