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Female genital tract shedding of HIV-1 is rare in women with suppressed HIV-1 in plasma
- Source :
- AIDS
- Publication Year :
- 2019
-
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.
- 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
Subjects
Details
- ISSN :
- 14735571
- Volume :
- 34
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- AIDS (London, England)
- Accession number :
- edsair.doi.dedup.....7288973ef793dfe6c2e5348d73361a37