Treatment of cervicitis is associated with decreased cervical shedding of HIV-1

• Published in: AIDS (London) Vol. 15; no. 1; pp. 105 - 110
• Main Authors: MCCLELLAND, R. Scott, WANG, Chia C, MANDALIYA, Kishorchandra, OVERBAUGH, Julie, REINER, Maureen T, PANTELEEFF, Dana D, LAVREYS, Ludo, NDINYA-ACHOLA, Jeckoniah, BWAYO, Job J, KREISS, Joan K
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 05.01.2001
• Subjects: Adult; AIDS-Related Opportunistic Infections - drug therapy; AIDS-Related Opportunistic Infections - epidemiology; AIDS-Related Opportunistic Infections - virology; AIDS/HIV; Anti-Bacterial Agents; Anti-Infective Agents - therapeutic use; Biological and medical sciences; cervix; Cervix Uteri - immunology; Cervix Uteri - virology; Chlamydia Infections - drug therapy; Chlamydia Infections - virology; Chlamydia trachomatis; Female; Gonorrhea - drug therapy; Gonorrhea - epidemiology; Gonorrhea - virology; HIV-1 - genetics; HIV-1 - isolation & purification; Human immunodeficiency virus 1; Human viral diseases; Humans; Infectious diseases; Kenya - epidemiology; Medical sciences; Middle Aged; Prevalence; Prospective Studies; RNA, Viral - metabolism; Tropical medicine; Uterine Cervicitis - drug therapy; Uterine Cervicitis - epidemiology; Uterine Cervicitis - virology; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Virus Shedding - drug effects; Women's Health; Kenya; Africa; Immunopathology; RNA; HIV-1 virus; Treatment efficiency; Mucosa; Transmission; Retroviridae; AIDS; Uterine cervix; Immune deficiency; Lentivirus; Female genital diseases; Infection; Virus; Chemotherapy; Microbiological investigation; Treatment; Viral disease; Risk factor; Female; Cervicitis; Human immunodeficiency virus; Uterine cervix diseases
• ISSN: 0269-9370; 1473-5571
• DOI: 10.1097/00002030-200101050-00015

To determine whether cervical mucosal shedding of HIV-1 RNA and HIV-1 infected cells decreases following successful treatment of cervicitis. Prospective interventional study. Sexually Transmitted Infections Clinic, Coast Provincial General Hospital, Mombasa, Kenya. Thirty-six HIV-1 seropositive women with cervicitis: 16 with Neisseria gonorrhoeae, seven with Chlamydia trachomatis, and 13 with non-specific cervicitis. Treatment of cervicitis. Levels of total (cell-free and cell-associated) HIV-1 RNA and presence of HIV-1 DNA (a marker for infected cells) in cervical secretions before and after resolution of cervicitis. After treatment of cervicitis, the median HIV-1 RNA concentration in cervical secretions was reduced from 4.05 to 3.24 log10 copies/swab (P = 0.001). Significant decreases in cervical HIV-1 RNA occurred in the subgroups with N. gonorrhoeae (3.94 to 3.28 log10 copies/swab; P = 0.02) and C. trachomatis (4.21 to 3.19 log10 copies/swab; P = 0.02). Overall, the prevalence of HIV-1 infected cells in cervical secretions also decreased after treatment, from 67% to 42% (odds ratio, 2.8; 95% confidence interval, 1.3-6.0; P = 0.009). Detection of infected cells was associated with higher mean HIV-1 RNA levels (4.04 versus 2.99 log10 copies/swab; P< 0.0001). Effective treatment of cervicitis resulted in significant decreases in shedding of HIV-1 virus and infected cells in cervical secretions. Treatment of sexually transmitted diseases may be an important means of decreasing the infectivity of HIV-1 seropositive women by reducing exposure to HIV-1 in genital secretions.