Trichomonas vaginalis Infections

  • Christina A. Muzny
  • Patricia KissingerEmail author


T. vaginalis, first thought to be a commensal, then a nuisance sexually transmitted infection (STI), is now gaining more recognition as an important contributor to reproductive morbidity and has been associated with HIV acquisition and transmission. T. vaginalis increases recruitment of CD4 cells in vaginal epithelium, disrupts epithelial barrier integrity, and alters vaginal microbiota, increasing risk for HIV transmission. Many persons with T. vaginalis are asymptomatic. Women who have symptoms typically have a vaginal discharge that is frothy, malodorous and yellow-green, as well as dysuria, itching, and/or vulvar irritation. Men who have symptoms exhibit urethritis. While T. vaginalis is not a reportable disease in the United States (US), some risk factors have been identified including increasing age, African American race, incarceration, and HIV infection. HIV-infected women have higher prevalence and recurrence rates of T. vaginalis compared to HIV-uninfected women, thus HIV-infected women should be screened regularly and those who test positive should be rescreened 3 months after treatment. Treatment recommendations are different for HIV-infected women; while the 2 g single dose metronidazole (MTZ) is recommended for HIV-uninfected women, the 7-day multi-dose of 500 mg twice daily is recommended for HIV-infected women. Differences in treatment response may be due to the high rate of comorbidity with bacterial vaginosis (BV), interactions between MTZ and anti-retroviral therapy or other hosts factors. T. vaginalis is generally susceptible to MTZ. HIV-infected persons with T. vaginalis are more likely to shed HIV in genital fluids and treatment of T. vaginalis reduces this HIV shedding, thus T. vaginalis control among HIV-infected persons is also of public health significance.


Trichomonas vaginalis Trichomoniasis HIV Epidemiology Treatment 


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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Division of Infectious Diseases, Department of MedicineUniversity of Alabama at BirminghamBirminghamUSA
  2. 2.EpidemiologyTulane University School of Public Health and Tropical MedicineNew OrleansUSA

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