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Genital ulceration does not increase HIV-1 shedding in cervical or vaginal secretions of women taking antiretroviral therapy.
- Source :
-
Sexually transmitted infections [Sex Transm Infect] 2011 Mar; Vol. 87 (2), pp. 114-7. Date of Electronic Publication: 2010 Oct 27. - Publication Year :
- 2011
-
Abstract
- Objectives: Genital ulcer disease (GUD) is associated with increased HIV-1-RNA shedding in antiretroviral therapy (ART)-naive women. The effect of GUD on HIV-1 shedding among ART-treated women is not known. The objective of this study was to test the hypothesis that genital ulcerations increase genital HIV-1-RNA shedding in women receiving ART.<br />Methods: Eligible women initiated ART and attended monthly visits with inspection for genital lesions and collection of genital swabs. GUD cases diagnosed after 2 months or more on ART were included for analysis and served as their own controls. HIV-1 RNA was quantitated in specimens collected before, during and after GUD for all cases. The lower limit of quantitation was 100 HIV-1-RNA copies/swab. Using the pre-GUD visit as the reference, the detection of genital HIV-1 RNA before versus during and after GUD episodes was compared.<br />Results: 36 women had GUD episodes after ART initiation. HIV-1 RNA was detected before, during and after GUD in cervical secretions from four (11%), one (3%) and six (17%) women, respectively, and in vaginal secretions from three (8%), four (11%) and four (11%) women, respectively. After adjustment for time on ART, there was no difference in the detection of cervical HIV-1 RNA before versus during GUD (adjusted OR 0.22, 95% CI 0.04 to 1.23). Likewise, GUD did not increase HIV-1 detection in vaginal secretions (adjusted OR 1.32, 95% CI 0.29 to 5.92).<br />Conclusions: GUD did not significantly increase cervical or vaginal HIV-1 shedding. The results suggest that ART maintains its effectiveness for genital HIV-1 suppression despite GUD episodes.
- Subjects :
- Adult
Anti-HIV Agents therapeutic use
Cervix Uteri metabolism
Cervix Uteri virology
Female
HIV Infections virology
Humans
Mucus virology
Prospective Studies
RNA, Viral analysis
Vagina metabolism
Vagina virology
HIV Infections drug therapy
HIV-1
Ulcer virology
Uterine Cervical Diseases virology
Vaginal Diseases virology
Virus Shedding
Subjects
Details
- Language :
- English
- ISSN :
- 1472-3263
- Volume :
- 87
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Sexually transmitted infections
- Publication Type :
- Academic Journal
- Accession number :
- 20980464
- Full Text :
- https://doi.org/10.1136/sti.2010.045369