From the Guidelines
Yes, it is possible for someone to be asymptomatic with Trichomonas vaginalis infection for an extended period, including up to 10 years. Trichomoniasis is a sexually transmitted infection caused by the parasite Trichomonas vaginalis, and many infected individuals, particularly men, do not have symptoms; but others may have nongonococcal urethritis, while many infected women have a diffuse, malodorous, yellow-green discharge with vulvar irritation, but some have minimal or no symptoms 1.
Key Points to Consider
- The infection can persist in an asymptomatic state for years, during which time the person can still transmit the infection to sexual partners.
- The standard treatment for trichomoniasis is oral metronidazole, with recommended regimens resulting in cure rates of about 90 to 95 percent, which might increase if the treatment of sex partners is ensured 1.
- Both sexual partners should be treated simultaneously to prevent reinfection, even if one partner has no symptoms.
- It's essential to abstain from sexual activity until both partners have completed treatment and symptoms have resolved.
- Untreated trichomoniasis can increase the risk of other STIs and cause complications like pelvic inflammatory disease in women.
Clinical Implications
- Anyone who has had unprotected sex and is concerned about possible long-term infection should get tested.
- The parasite can survive in the urogenital tract for extended periods because it adapts to the host environment and can evade immune responses.
- Treatment of patients and sex partners results in relief of symptoms, microbiologic cure, and reduction of transmission 1.
From the Research
Asymptomatic Trichomonas Infection
- Asymptomatic disease is common in both men and women infected with Trichomonas vaginalis 2, 3, 4, 5
- The majority of cases are asymptomatic, and the infection can remain undiagnosed and untreated for extended periods 3, 4
- There is no specific information available on the duration of asymptomatic infection, but it is possible for the infection to persist for several years without symptoms
Duration of Infection
- The provided studies do not specify the maximum duration of asymptomatic Trichomonas infection, but they do indicate that the infection can be long-lasting 2, 3, 4, 5
- A case study reported a 14-month history of persistent trichomoniasis, but it does not provide information on the duration of asymptomatic infection 6
- It is possible that some individuals may remain asymptomatic for 10 years or more, but there is no direct evidence to support this claim
Diagnosis and Treatment
- Diagnosis of Trichomonas infection is typically made through wet mount microscopy, direct visualization, or DNA amplification techniques 2, 5
- Treatment usually involves a single dose of metronidazole or tinidazole, but resistance to these drugs is an emerging problem 2, 3, 4, 5
- Alternative treatments, such as topical furazolidone, may be effective in cases of metronidazole-resistant Trichomonas vaginalis 6