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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Cervicovaginal HIV-1 shedding in women taking antiretroviral therapy in burkina faso: A longitudinal study
Journal of Acquired Immune Deficiency Syndromes, Volume 65, No. 2, Year 2014
Notification
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Description
Background: Antiretroviral therapy (ART) reduces transmission of HIV-1. However, genital HIV-1 can be detected in patients on ART. We analyzed factors associated with genital HIV-1 shedding among high-risk women on ART in Burkina Faso. Methods: Plasma viral load (PVL) and enriched cervicovaginal lavage HIV-1 RNA were measured every 3-6 months for up to 8 years. Random-effects logistic and linear regression models were used to analyze associations of frequency and quantity of genital HIV-1 RNA with behavioral and biological factors, adjusting for within-woman correlation. The lower limit of detection of HIV-1 RNA in plasma and eCVL samples was 300 copies per milliliter. Results: One hundred and eighty-eight participants initiated ART from 2004 to 2011. PVL was detectable in 16% (171/1050) of visits, in 52% (90/174) of women. Cervicovaginal HIV-1 RNA was detectable in 16% (128/798) of visits with undetectable plasma HIV-1 RNA in 45% (77/170) of women. After adjusting for PVL, detectable cervicovaginal HIV-1 RNA was independently associated with abnormal vaginal discharge and use of nevirapine or zidovudine vs. efavirenz and stavudine, respectively; longer time on ART and hormonal contraception were not associated with increased shedding. The presence of bacterial vaginosis, herpes simplex virus-2 DNA, and the use of nevirapine vs efavirenz were independently associated with an increased quantity of cervicovaginal HIV-1 RNA. Conclusions: Certain ART regimens, abnormal vaginal discharge, bacterial vaginosis, and genital herpes simplex virus-2 are associated with HIV-1 cervicovaginal shedding or quantity in women on ART after adjusting for PVL. This may reduce the effectiveness of ART as prevention in high-risk populations. Copyright © 2013 by Lippincott Williams and Wilkins.
Authors & Co-Authors
Low, Andrea Jane
Unknown Affiliation
Konaté, Issouf
Unknown Affiliation
Nagot, Nicolas
Unknown Affiliation
Weiss, Helen Anne
Unknown Affiliation
Kania, Dramane
Unknown Affiliation
Vickerman, Peter T.
Unknown Affiliation
Segondy, Michel
Unknown Affiliation
Mabey, David C.W.
Unknown Affiliation
Morris, Lynn G.
Unknown Affiliation
Méda, Nicolas Yelbomkan
Unknown Affiliation
van de Perre, Philippe
Unknown Affiliation
Mayaud, Philippe C.
Unknown Affiliation
Bahembera, Eloi
Unknown Affiliation
Berthé, Abdramane
Unknown Affiliation
Coulibaly, Minata
Unknown Affiliation
Defer, Marie Christine
Unknown Affiliation
Diallo, Ramata
Unknown Affiliation
Djagbaré, Didier
Unknown Affiliation
Huët, Charlotte
Unknown Affiliation
Ky-Dama, Florent
Unknown Affiliation
M'Boutiki, Gilles T.
Unknown Affiliation
Millogo, Ines
Unknown Affiliation
Ouédraogo, Abdoulaye V.
Unknown Affiliation
Ouédraogo, Djénéba Sanon
Unknown Affiliation
Rouet, François
Unknown Affiliation
Sanon, Anselme
Unknown Affiliation
Sawadogo, Haoua
Unknown Affiliation
Vallo, Roselyne
Unknown Affiliation
Vergne, Laurence
Unknown Affiliation
Foulongne, Vincent
Unknown Affiliation
Andonaba, Jean Baptiste
Unknown Affiliation
Sawadogo, Adrien Bruno
Unknown Affiliation
Statistics
Citations: 32
Authors: 32
Affiliations: 7
Identifiers
Doi:
10.1097/QAI.0000000000000049
ISSN:
15254135
Research Areas
Genetics And Genomics
Infectious Diseases
Sexual And Reproductive Health
Study Design
Cohort Study
Study Approach
Quantitative
Study Locations
Burkina Faso
Participants Gender
Female