1. Self-collected genital swabs compared with cervicovaginal lavage for measuring HIV-1 and HSV-2 and the effect of acyclovir on viral shedding.
- Author
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McNicholl, Janet M., Leelawiwat, Wanna, Whitehead, Sara, Hanson, Debra L., Evans-Strickfaden, Tammy, Cheng, Chen Y., Chonwattana, Wannee, Mueanpai, Famui, Kittinunvorakoon, Chonticha, Markowitz, Lauri, and Dunne, Eileen F.
- Subjects
MULTIVARIATE analysis ,SURGICAL swabs ,ACYCLOVIR ,VIRAL shedding ,CLINICAL trials ,HIV infection transmission ,ANTIVIRAL agents ,COMPARATIVE studies ,HERPES genitalis ,HERPESVIRUSES ,HIV ,HIV infections ,IRRIGATION (Medicine) ,RESEARCH methodology ,MEDICAL cooperation ,RESEARCH ,VIRAL physiology ,VIRAL load ,ANTIRETROVIRAL agents ,EVALUATION research ,RETROSPECTIVE studies ,MIXED infections ,PHYSIOLOGY ,INFECTIOUS disease transmission ,THERAPEUTICS - Abstract
HIV-1 and HSV-2 are frequent genital co-infections in women. To determine how self-collected genital swabs compare to provider-collected cervicovaginal lavage, paired self-collected genital swabs and cervicovaginal lavage from women co-infected with HIV-1 and HSV-2 were evaluated. Women were in an acyclovir clinical trial and their samples were tested for HIV-1 RNA (361 samples) and HSV-2 DNA (378 samples). Virus shedding, quantity and acyclovir effect were compared. HIV-1 and HSV-2 were more frequently detected in self-collected genital swabs: 74.5% of self-collected genital swabs and 63.6% of cervicovaginal lavage had detectable HIV-1 (p ≤ 0.001, Fisher's exact test) and 29.7% of self-collected genital swabs and 19.3% of cervicovaginal lavage had detectable HSV-2 (p ≤ 0.001) in the placebo month. Cervicovaginal lavage and self-collected genital swabs virus levels were correlated (Spearman's rho, 0.68 for HIV; 0.61 for HSV-2) and self-collected genital swabs levels were generally higher. In multivariate modeling, self-collected genital swabs and cervicovaginal lavage could equally detect the virus-suppressive effect of acyclovir: for HIV-1, proportional odds ratios were 0.42 and 0.47 and for HSV-2, they were 0.10 and 0.03 for self-collected genital swabs and cervicovaginal lavage, respectively. Self-collected genital swabs should be considered for detection and measurement of HIV-1 and HSV-2 in clinical trials and other studies as they are a sensitive method to detect virus and can be collected in the home with frequent sampling. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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