Comparison of cervicovaginal lavage, cervicovaginal lavage enriched with cervical swab, and vaginal tampon for the detection of HIV-1 RNA and HSV-2 DNA in genital secretions

• Published in: Journal of acquired immune deficiency syndromes (1999) Vol. 49; no. 4; p. 406
• Main Authors: Delany, Sinéad, Rosas, Raul, Mlaba, Nonkululeko, Clayton, Tim, Akpomiemie, Godspower, LeGoff, Jérôme, Capovilla, Alexio, Bélec, Laurent, Stevens, Wendy, Mayaud, Philippe
• Format: Journal Article
• Language: English
• Published: United States 01.12.2008
• Subjects: Adolescent; Adult; Cervix Uteri - metabolism; Cervix Uteri - virology; DNA, Viral - isolation & purification; Female; Genitalia, Female - metabolism; Genitalia, Female - virology; Herpes Genitalis - complications; Herpes Genitalis - diagnosis; Herpes Genitalis - virology; Herpesvirus 2, Human - genetics; Herpesvirus 2, Human - isolation & purification; HIV Infections - complications; HIV Infections - diagnosis; HIV Infections - virology; HIV-1 - genetics; HIV-1 - isolation & purification; Humans; Menstrual Hygiene Products; RNA, Viral - isolation & purification; Specimen Handling - instrumentation; Therapeutic Irrigation; Vagina - metabolism; Vagina - virology; Young Adult
• ISSN: 1525-4135
• DOI: 10.1097/QAI.0b013e31818c7f75

We compared the performance of 3 collection methods for cervicovaginal secretions [cervicovaginal lavage (CVL), CVL enriched with a cervical swab (eCVL), and vaginal tampon (VT)] to identify the most reliable method for detection of cervicovaginal HIV-1 and herpes simplex virus type 2 (HSV-2). HIV-1 RNA (Nuclisens EasyQ; BioMerieux, Marcy-l'Etoile, France), HSV-2 DNA (real-time polymerase chain reaction), and microscopic blood and semen traces were detected in samples from 19 HIV-1-HSV-2-coinfected women seen at 4 weekly visits. HIV-1 RNA was detected in 49 (79%) of 62 eCVLs, 41 (61%) of 67 CVLs, and 27 (57%) of 47 VTs. Detection of HIV-1 RNA was higher in eCVL compared with CVL [45/58 (78%) vs. 32/58 (55%); risk ratio 1.41, 95% confidence interval 1.05 to 1.88]. Although more eCVLs were contaminated with microscopic blood (29%) than CVLs (22%) or VTs (7%), detection of HIV-1 RNA remained higher using eCVL compared with CVL (risk ratio 1.43, 95% confidence interval 1.02 to 2.02) in uncontaminated samples. HSV-2 DNA was detected in less than 10% of samples by each method but in 7 (37%) of 19 women overall by 1 or more methods.