Cervical Shedding of HIV-1 RNA Among Women With Low Levels of Viremia While Receiving Highly Active Antiretroviral Therapy
Year: 2006
Type: article
Abstract: BACKGROUND: Among women with low or undetectable quantities of HIV-1 RNA in plasma, factors associated with genital HIV-1 RNA shedding, including choice of treatment regimen, are poorly characterized. METHODS: We measured HIV-1 RNA in cervical swab specimens obtained from participants in the Women's Interagency HIV Study who had concurrent plasma viral RNA levels <500 copies/mL, and we assessed factors associated with genital HIV shedding. The study was powered to determine the relative effects of antiretroviral protease inhibitors (PIs) versus nonnucleoside reverse transcriptase inhibitors (NNRTIs) on viral RNA shedding. RESULTS: Overall, 44 (15%) of 290 women had detectable HIV-1 RNA in cervical specimens. In the final multivariate model, shedding was independently associated with NNRTI (vs. PI) use (odds ratio [OR], 95% confidence interval [CI]: 2.24, 1.13 to 4.45) and illicit drug use (OR, 95% CI: 2.41, 0.96 to 5.69). CONCLUSIONS: This is the largest study to define risks for genital HIV-1 RNA shedding in women with low/undetectable plasma virus. Shedding in this population was common, and NNRTI-based highly active antiretroviral therapy (HAART) (vs. PI-based HAART) was associated with genital HIV shedding. Further study is required to determine the impact of these findings on transmission of HIV from mother to child or to sexual partners.
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: G1025189317, HCV and HIV Progression in Women on HAART, G1290148215, G2462901743, The Connie Wofsy Women's HIV Study, G3414024915, Brooklyn Women's Interagency HIV Study (WIHS) V, G3575724264, G4350804880, WIHS Data Management and Analysis Center (WDMAC), G4538066223, Southern California Women's Interagency HIV Study Consortium, General Clinical Research Center, G498379488, Chicago WIHS Consortium V (CWC), G508464731, Washington Women's Interagency HIV/AIDS Study, G699655281, G7028732214, HIV AND HCV DISEASE PROGRESSION IN WOMEN ON HAART, G769023845, Women's Interagency HIV Study (WIHS-V), General Clinical Research Center
OpenAlex ID: W1984083381