Infectious correlates of HIV-1 shedding in the female upper and lower genital tracts.

Authors

• Jenell S Coleman
• Jane Hitti
• Elizabeth A Bukusi
• Christina Mwachari
• Angela Muliro
• Rosemary Nguti
• Reggie Gausman
• Sarah Jensen
• Dorothy Patton
• David Lockhart
• Robert Coombs
• Craig R Cohen

Publication/Presentation Date

3-30-2007

Abstract

OBJECTIVES: To determine the effects of vaginal, cervical, and endometrial infections on shedding of HIV-1 RNA in the female genital tract.

DESIGN: Cross-sectional.

METHODS: Antiretroviral-naive women from Nairobi, Kenya with CD4 cell counts >or= 350 cells/mul had plasma and endocervical wick samples collected for HIV quantification by real-time RNA reverse transcriptase-polymerase chain reaction. Vaginal and cervical Gram stains and endometrial biopsies were obtained. Vaginal Gram stain was used to diagnose bacterial vaginosis and to quantify Lactobacillus levels.

RESULTS: Twenty-six of 50 (52%) women had detectable endocervical HIV-1 RNA with a median endocervical viral load of 1760 copies/ml (range: undetectable to 1 1,030,000 copies/ml). Women with decreased Lactobacillus had 15.8-fold [95% confidence interval (CI), 2.0-123] greater endocervical HIV-1 RNA than women with normal Lactobacillus levels. Women with plasma cell (PC) endometritis [>or= 1 PC/high-power field (hpf)] had a 15.8-fold (95% CI, 2.0-120) higher endocervical HIV RNA level than women without PC endometritis. Both these associations remained after controlling for plasma viral load. Cervicitis (>or= 30 polymorphonuclear leukocytes/hpf), however, was not associated with endocervical HIV-1 RNA shedding (P = 0.81).

CONCLUSIONS: In HIV-1-infected, antiretroviral-naive women without symptoms of pelvic inflammatory disease infection, abnormal vaginal flora and inflammatory cells in the endometrium affected HIV-1 shedding from the lower genital tract. These data suggest that both the upper and lower genital tracts contribute to female HIV-1 genital shedding.

Volume

21

Issue

6

First Page

755

Last Page

759

ISSN

0269-9370

Published In/Presented At

Coleman, J. S., Hitti, J., Bukusi, E. A., Mwachari, C., Muliro, A., Nguti, R., Gausman, R., Jensen, S., Patton, D., Lockhart, D., Coombs, R., & Cohen, C. R. (2007). Infectious correlates of HIV-1 shedding in the female upper and lower genital tracts. AIDS (London, England), 21(6), 755–759. https://doi.org/10.1097/QAD.0b013e328012b838

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

17413697

Department(s)

Administration and Leadership

Document Type

Article