Association between paired plasma and cervicovaginal lavage fluid HIV-1 RNA levels during 36 months.

TitleAssociation between paired plasma and cervicovaginal lavage fluid HIV-1 RNA levels during 36 months.
Publication TypeJournal Article
Year of Publication2006
AuthorsCu-Uvin S, Snyder B, Harwell JI, Hogan J, Chibwesha C, Hanley D, Ingersoll J, Kurpewski J, Mayer KH, Caliendo AM
JournalJ Acquir Immune Defic Syndr
Volume42
Issue5
Pagination584-7
Date Published2006 Aug 15
ISSN1525-4135
KeywordsAntiretroviral Therapy, Highly Active, Female, HIV Infections, HIV-1, Humans, RNA, Viral, Statistics as Topic, Vagina, Vaginal Douching, Viral Load, Viremia
Abstract

OBJECTIVE: To determine the patterns and predictors of genital tract HIV-1 RNA levels during a 36-month period.

METHODS: HIV-1 RNA levels were measured blood in plasma and the genital tract (by cervicovaginal lavage [CVL]) at baseline before highly, active antiretroviral therapy, at 2 and 4 weeks and every 6 months. Viral loads were measured using nucleic acid sequence-based amplification assay with a lower limit of detection of 2.6 log10 copies/mL.

RESULTS: Ninety-seven women had a median of 30.4 months' follow-up, with 530 paired PVL and CVL specimens. The strongest predictor of CVL fluid HIV-1 RNA detection was PVL of more than 2.6 log10 copies/mL, with an odds ratio of 13.7 (P < 0.0001). Each log10 unit increase in PVL increased the odds of detecting HIV-1 RNA in CVL fluid by 2.6 folds (P = 0.0002). Cervicovaginal lavage fluid HIV-1 RNA exceeded PVL on 5% of visits. When patients achieved undetectable levels of HIV-1 RNA in both plasma and CVL fluid, rebound of HIV-1 RNA occurred in plasma first or concurrently with CVL fluid HIV-1 RNA.

CONCLUSIONS: Plasma viral load is the strongest predictor of CVL fluid HIV-1 RNA detection. Cervicovaginal lavage fluid HIV-1 RNA levels are generally lower than PVL. Plasma viral load is more likely to rebound first or at the same time as CVL fluid viral load.

DOI10.1097/01.qai.0000229997.52246.95
Alternate JournalJ. Acquir. Immune Defic. Syndr.
PubMed ID16837866
Grant ListAI50409 / AI / NIAID NIH HHS / United States
K12 HD043447 / HD / NICHD NIH HHS / United States
K24 AI066884 / AI / NIAID NIH HHS / United States
P30AI42853 / AI / NIAID NIH HHS / United States
R01 AI40350 / AI / NIAID NIH HHS / United States
U01AI146381 / AI / NIAID NIH HHS / United States