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.
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.
Authors: Maria M Bednar; Christa Buckheit Sturdevant; Lauren A Tompkins; Kathryn Twigg Arrildt; Elena Dukhovlinova; Laura P Kincer; Ronald Swanstrom Journal: Curr HIV/AIDS Rep Date: 2015-06 Impact factor: 5.071
Authors: Kartik K Venkatesh; Allison K DeLong; Rami Kantor; Stacey Chapman; Jessica Ingersoll; Jaclynn Kurpewski; Maria Pia De Pasquale; Richard D'Aquila; Angela M Caliendo; Susan Cu-Uvin Journal: J Womens Health (Larchmt) Date: 2013-03-26 Impact factor: 2.681
Authors: Mimi Ghosh; John V Fahey; Zheng Shen; Timothy Lahey; Susan Cu-Uvin; Zhijin Wu; Kenneth Mayer; Peter F Wright; John C Kappes; Christina Ochsenbauer; Charles R Wira Journal: PLoS One Date: 2010-06-29 Impact factor: 3.240