Treatment Of Cervicitis Is Associated With Decreased Cervical Shedding Of Hiv-1. AIDS

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Date
2001-01-05Author
Mcclelland, R S
Wang, C C
Mandaliya, K
Overbaugh, J
Reiner, M T
Panteleeff, D D
Lavreys, L
Ndinya-Achola, JO
wayo, J J
Kreiss ., J K
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ArticleLanguage
enMetadata
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OBJECTIVE: To determine whether cervical mucosal shedding of HIV-1 RNA and HIV-1 infected cells decreases following successful treatment of cervicitis. DESIGN: Prospective interventional study. SETTING: Sexually Transmitted Infections Clinic, Coast Provincial General Hospital, Mombasa, Kenya. PARTICIPANTS: Thirty-six HIV-1 seropositive women with cervicitis: 16 with Neisseria gonorrhoeae, seven with Chlamydia trachomatis, and 13 with non-specific cervicitis. INTERVENTIONS: Treatment of cervicitis. Main outcome measures: Levels of total (cell-free and cell-associated) HIV-1 RNA and presence of HIV-1 DNA (a marker for infected cells) in cervical secretions before and after resolution of cervicitis. RESULTS: After treatment of cervicitis, the median HIV-1 RNA concentration in cervical secretions was reduced from 4.05 to 3.24 log10 copies/swab (P = 0.001). Significant decreases in cervical HIV-1 RNA occurred in the subgroups with N. gonorrhoeae (3.94 to 3.28 log10 copies/swab; P = 0.02) and C. trachomatis (4.21 to 3.19 log10 copies/swab; P = 0.02). Overall, the prevalence of HIV-1 infected cells in cervical secretions also decreased after treatment, from 67% to 42% (odds ratio, 2.8; 95% confidence interval, 1.3-6.0; P = 0.009). Detection of infected cells was associated with higher mean HIV-1 RNA levels (4.04 versus 2.99 log10 copies/swab; P< 0.0001). CONCLUSIONS: Effective treatment of cervicitis resulted in significant decreases in shedding of HIV-1 virus and infected cells in cervical secretions. Treatment of sexually transmitted diseases may be an important means of decreasing the infectivity of HIV-1 seropositive women by reducing exposure to HIV-1 in genital secretions.
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Http://profiles.uonbi.ac.ke/jndinya/publications/mcclelland-rs-wang-cc-mandaliya-k-overbaugh-j-reiner-mt-panteleeff-dd-lavreys-lhttp://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/28286
http://www.ncbi.nlm.nih.gov/pubmed/11192850
Citation
Mcclelland Rs, Wang Cc, Mandaliya K, Overbaugh J, Reiner Mt, Panteleeff Dd, Lavreys L, Ndinya-achola J, Bwayo Jj, Kreiss Jk.treatment Of Cervicitis Is Associated With Decreased Cervical Shedding Of Hiv-1.aids. 2001 Jan 5;15(1):105-10., O., Prof. Ndinya-achola J. , Aids. 2001 Jan 5;15(1):105-10., (2001)Publisher
School of medicine
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- Faculty of Health Sciences (FHS) [10227]