Female genital tract shedding of HIV-1 is rare in women with suppressed HIV-1 in plasma

Julie A.E. Nelson, Kristina De Paris, Catalina Ramirez, Andrew Edmonds, Katie R. Mollan, Camden P. Bay, Kara Compliment, Betsy C. Herold, Kathryn Anastos, Howard Minkoff, Seble Kassaye, Dominika L. Seidman, Audrey L. French, Elizabeth T. Golub, Anandi N. Sheth, Christina Ochsenbauer, Ronald Swanstrom, Joseph J. Eron, Adaora A. Adimora

Research output: Contribution to journalArticle

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 20-4000copies/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 668copies/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.

Original languageEnglish (US)
Pages (from-to)39-46
Number of pages8
JournalAIDS
Volume34
Issue number1
DOIs
StatePublished - Jan 1 2020

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Keywords

  • Women's Interagency HIV Study
  • cervicovaginal lavage
  • genital HIV-1 shedding
  • genital inflammation
  • inflammation biomarkers
  • suppressed
  • women

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

Cite this

Nelson, J. A. E., De Paris, K., Ramirez, C., Edmonds, A., Mollan, K. R., Bay, C. P., Compliment, K., Herold, B. C., Anastos, K., Minkoff, H., Kassaye, S., Seidman, D. L., French, A. L., Golub, E. T., Sheth, A. N., Ochsenbauer, C., Swanstrom, R., Eron, J. J., & Adimora, A. A. (2020). Female genital tract shedding of HIV-1 is rare in women with suppressed HIV-1 in plasma. AIDS, 34(1), 39-46. https://doi.org/10.1097/QAD.0000000000002373