Infectious correlates of HIV-1 shedding in the female upper and lower genital tracts.
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Date
2007Author
Coleman, JS
Hitti, J
Bukusi, EA
Mwachari, C
Muliro, A
Nguti, R
Gausman, R
Jensen, S
Patton, D
Lockhart, D
Coombs, R
Cohen, CR
Type
ArticleLanguage
enMetadata
Show full item recordAbstract
To determine the effects of vaginal, cervical, and endometrial infections on shedding of HIV-1 RNA in the female genital tract.
Cross-sectional.
Antiretroviral-naive women from Nairobi, Kenya with CD4 cell counts >or= 350 cells/mul had plasma and endocervical wick samples collected for HIV quantification by real-time RNA reverse transcriptase-polymerase chain reaction. Vaginal and cervical Gram stains and endometrial biopsies were obtained. Vaginal Gram stain was used to diagnose bacterial vaginosis and to quantify Lactobacillus levels.
Twenty-six of 50 (52%) women had detectable endocervical HIV-1 RNA with a median endocervical viral load of 1760 copies/ml (range: undetectable to 1 1,030,000 copies/ml). Women with decreased Lactobacillus had 15.8-fold [95% confidence interval (CI), 2.0-123] greater endocervical HIV-1 RNA than women with normal Lactobacillus levels. Women with plasma cell (PC) endometritis [>or= 1 PC/high-power field (hpf)] had a 15.8-fold (95% CI, 2.0-120) higher endocervical HIV RNA level than women without PC endometritis. Both these associations remained after controlling for plasma viral load. Cervicitis (>or= 30 polymorphonuclear leukocytes/hpf), however, was not associated with endocervical HIV-1 RNA shedding (P = 0.81).
In HIV-1-infected, antiretroviral-naive women without symptoms of pelvic inflammatory disease infection, abnormal vaginal flora and inflammatory cells in the endometrium affected HIV-1 shedding from the lower genital tract. These data suggest that both the upper and lower genital tracts contribute to female HIV-1 genital shedding.
URI
http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/32388http://www.ncbi.nlm.nih.gov/pubmed/17413697
Citation
AIDS. 2007 Mar 30;21(6):755-9.Publisher
Department of Obstetrics and Gynaecology
Collections
- Faculty of Health Sciences (FHS) [10378]