1. Female genital tract shedding of HIV-1 is rare in women with suppressed HIV-1 in plasma
- Author
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Katie R. Mollan, Andrew Edmonds, Kara Compliment, Kathryn Anastos, Joseph J. Eron, Betsy C. Herold, Adaora A. Adimora, Christina Ochsenbauer, Audrey L. French, Elizabeth T. Golub, Anandi N. Sheth, Ronald Swanstrom, Howard Minkoff, Camden P. Bay, Dominika Seidman, Seble Kassaye, Kristina De Paris, Julie A. E. Nelson, and Catalina Ramirez
- Subjects
0301 basic medicine ,Female circumcision ,Adult ,medicine.medical_specialty ,Anti-HIV Agents ,Immunology ,Human immunodeficiency virus (HIV) ,Inflammation ,Cervix Uteri ,medicine.disease_cause ,Gastroenterology ,Article ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Interquartile range ,Internal medicine ,HIV Seropositivity ,medicine ,Immunology and Allergy ,Humans ,Sex organ ,030212 general & internal medicine ,Viremia ,Inflammation biomarkers ,business.industry ,Women's Interagency HIV Study ,Middle Aged ,Viral Load ,Antiretroviral therapy ,Virus Shedding ,030104 developmental biology ,Infectious Diseases ,Cross-Sectional Studies ,Logistic Models ,Vagina ,HIV-1 ,RNA, Viral ,Female ,medicine.symptom ,business ,Biomarkers - Abstract
OBJECTIVE Determine the frequency of genital HIV-1 shedding in a large cohort of women on long-term suppressive antiretroviral therapy (ART) and its association with mucosal inflammation. DESIGN We measured levels of HIV-1 RNA and inflammation biomarkers in cervicovaginal lavage (CVL) from HIV-seropositive women enrolled in the Women's Interagency HIV Study (WIHS). METHODS HIV-1 was quantified (Abbott RealTime HIV-1 assay) from CVL samples of 332 WIHS participants with and without clinical evidence of genital inflammation at the time of CVL collection; participants had suppressed plasma viral load (PVL; limit of quantitation less than 20-4000 copies/ml depending on year of collection) for a median of 7.1 years [interquartile range (IQR) 3.4-9.8, Group 1] or for a median of 1.0 years (IQR = 0.5-1.0, Group 2). Twenty-two biomarkers of inflammation were measured in CVL to compare with clinical markers. RESULTS HIV-1 was detected in 47% of 38 pre-ART CVL samples (median 668 copies/ml) and detection in CVL was associated with higher pre-ART PVL. HIV-1 was detected in only 1 of 38 CVL samples from these women on suppressive antiretroviral therapy for 1 year. No HIV-1 RNA was detected in 294 CVL samples from a cross-sectional set of women with suppressed PVL for a median of 7 years. Clinical inflammation markers were correlated with inflammatory biomarkers in CVL specimens, although genital inflammation was not associated with measurable genital HIV-1 shedding in these WIHS participants on ART. CONCLUSION ART that suppresses HIV-1 in the plasma of women also prevents genital tract HIV-1 shedding, even in the presence of genital tract inflammation.
- Published
- 2019