Effect of acquisition and treatment of cervical infections on HIV-1 shedding in women on antiretroviral therapy
Date
2010Author
Gitau, Ruth W.
Graham, Susan M.
Masese, Linnet N.
Overbaugh, Julie
Chohan, Vrasha
Peshu, Norbert
Richardson, Barbra A.
Jaoko Walter G.
Ndinya-Achola JO
McClelland, R. Scott
Type
ArticleLanguage
enMetadata
Show full item recordAbstract
BACKGROUND:
Cervicitis increases the quantity of HIV-1 RNA in cervical secretions when women are not taking antiretroviral therapy (ART), and successful treatment of cervicitis reduces HIV-1 shedding in this setting.
OBJECTIVE:
To determine the effect of acquisition and treatment of cervical infections on genital HIV-1 shedding in women receiving ART.
DESIGN:
Prospective cohort study.
METHODS:
We followed 147 women on ART monthly for incident nonspecific cervicitis, gonorrhea, and chlamydia. Cervical swabs for HIV-1 RNA quantitation were collected at every visit. The lower limit for linear quantitation was 100 copies per swab. We compared the prevalence of HIV-1 RNA detection before (baseline) versus during and after treatment of cervical infections.
RESULTS:
Thirty women contributed a total of 31 successfully treated episodes of nonspecific cervicitis (N = 13), gonorrhea (N = 17), and chlamydia (N = 1). HIV-1 RNA was detected in cervical secretions before, during, and after cervicitis at one (3.2%), five (16.1%), and three (9.7%) visits, respectively. Compared with baseline, detection of HIV-1 RNA was increased when cervical infections were present (adjusted odds ratio 5.7, 95% confidence interval 1.0-30.3, P = 0.04). However, even in the subset of women with cervical HIV-1 RNA levels above the threshold for quantitation, most had low concentrations during cervical infections (median 115, range 100-820 copies per swab).
CONCLUSION:
Although these data show a statistically significant increase in cervical HIV-1 RNA detection when cervical infections are present, most cervical HIV-1 RNA concentrations were near the threshold for detection, suggesting that infectivity remains low. Antiretroviral therapy appears to limit increases in genital HIV-1 shedding caused by cervical infections.
URI
http://www.ncbi.nlm.nih.gov/pubmed/20871388http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/9944
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2978313/
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- Faculty of Health Sciences (FHS) [10387]