@article{26530520c05a4f018cba4c5507c5a76b,
title = "Female genital tract shedding of HIV-1 is rare in women with suppressed HIV-1 in plasma",
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.",
keywords = "Women's Interagency HIV Study, cervicovaginal lavage, genital HIV-1 shedding, genital inflammation, inflammation biomarkers, suppressed, women",
author = "Nelson, {Julie A.E.} and {De Paris}, Kristina and Catalina Ramirez and Andrew Edmonds and Mollan, {Katie R.} and Bay, {Camden P.} and Kara Compliment and Herold, {Betsy C.} and Kathryn Anastos and Howard Minkoff and Seble Kassaye and Seidman, {Dominika L.} and French, {Audrey L.} and Golub, {Elizabeth T.} and Sheth, {Anandi N.} and Christina Ochsenbauer and Ronald Swanstrom and Eron, {Joseph J.} and Adimora, {Adaora A.}",
note = "Funding Information: Data in this manuscript were collected by the Women{\textquoteright}s Interagency HIV Study (WIHS). The contents of this publication are solely the responsibility of the authors and do not represent the official views of the National Institutes of Health (NIH). WIHS (Principal Investigators): UAB-MS WIHS (Mirjam-Colette Kempf and Deborah Konkle-Parker), U01-AI-103401; Atlanta WIHS (Ighovwerha Ofotokun, Anandi Sheth, and Gina Wingood), U01-AI-103408; Bronx WIHS (Kathryn Anastos and Anjali Sharma), U01-AI-035004; Brooklyn WIHS (Deborah Gustafson and Tracey Wilson), U01-AI-031834; Chicago WIHS (Mardge Cohen and Audrey French), U01-AI-034993; Metropolitan Washington WIHS (Seble Kassaye and Daniel Merenstein), U01-AI-034994; Miami WIHS (Maria Alcaide, Margaret Fischl, and Deborah Jones), U01-AI-103397; UNC WIHS (Adaora Adimora), U01-AI-103390; Connie Wofsy Women{\textquoteright}s HIV Study, Northern California (Bradley Aouizerat and Phyllis Tien), U01-AI-034989; WIHS Data Management and Analysis Center (Stephen Gange and Elizabeth Golub), U01-AI-042590; Southern California WIHS (Joel Milam), U01-HD-032632 (WIHS I – WIHS IV). The WIHS is funded primarily by the National Institute of Allergy and Infectious Diseases (NIAID), with additional co-funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Cancer Institute (NCI), the National Institute on Drug Abuse (NIDA), and the National Institute on Mental Health (NIMH). Targeted supplemental funding for specific projects is also provided by the National Institute of Dental and Craniofacial Research (NIDCR), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute on Deafness and other Communication Disorders (NIDCD), and the NIH Office of Research on Women{\textquoteright}s Health. WIHS data collection is also supported by UL1-TR000004 (UCSF CTSA), UL1-TR000454 (Atlanta CTSA), P30-AI-050410 (UNC CFAR), and P30-AI-027767 (UAB CFAR). Funding Information: This study was funded by the National Institutes of Health through the WIHS (U01 AI103390), the UNC Center for AIDS Research (P01 AI050410), and the other WIHS sites (U01-AI-103401, U01-AI-103408, U01-AI-035004, U01-AI-031834, U01-AI-034993, U01-AI-034994, U01-AI-103397, U01-AI-034989, U01-AI-042590, U01-HD-032632). WIHS data collection is also supported by NIH grants UL1-TR000004, UL1-TR000454, P30-AI-050410, and P30-AI-027767. Publisher Copyright: Copyright {\textcopyright} 2019 The Author(s).",
year = "2020",
month = jan,
day = "1",
doi = "10.1097/QAD.0000000000002373",
language = "English (US)",
volume = "34",
pages = "39--46",
journal = "AIDS",
issn = "0269-9370",
publisher = "Lippincott Williams and Wilkins",
number = "1",
}
