OBJECTIVES:Nigerian women reportedly apply lime juice intravaginally to protect themselves against HIV. In vitro data suggest that lime juice is virucidal, but only at cytotoxic concentrations. This is the first controlled, randomized safety trial of lime juice applied to the human vagina. METHODS:Forty-seven women were randomized to apply water or lime juice (25%, 50%, or undiluted) intravaginally twice daily for two 6-day intervals, separated by a 3-week washout period. Product application also was randomized: during 1 interval, product was applied using a saturated tampon and in the other by douche. Vaginal pH, symptoms, signs of irritation observed via naked eye examination and colposcopy, microflora, and markers of inflammation in cervicovaginal lavages were evaluated after 1 hour and on days 3 and 7. RESULTS: The largest reduction in pH was about one-half a pH unit, seen 1 hour after douching with 100% lime juice. We observed a dose-dependent pattern of symptoms and clinical and laboratory findings that were consistent with a compromised vaginal barrier function. CONCLUSIONS: The brief reduction in pH after vaginal lime juice application is unlikely to be virucidal in the presence of semen. Lime juice is unlikely to protect against HIV and may actually be harmful.
RCT Entities:
OBJECTIVES: Nigerian women reportedly apply lime juice intravaginally to protect themselves against HIV. In vitro data suggest that lime juice is virucidal, but only at cytotoxic concentrations. This is the first controlled, randomized safety trial of lime juice applied to the human vagina. METHODS: Forty-seven women were randomized to apply water or lime juice (25%, 50%, or undiluted) intravaginally twice daily for two 6-day intervals, separated by a 3-week washout period. Product application also was randomized: during 1 interval, product was applied using a saturated tampon and in the other by douche. Vaginal pH, symptoms, signs of irritation observed via naked eye examination and colposcopy, microflora, and markers of inflammation in cervicovaginal lavages were evaluated after 1 hour and on days 3 and 7. RESULTS: The largest reduction in pH was about one-half a pH unit, seen 1 hour after douching with 100% lime juice. We observed a dose-dependent pattern of symptoms and clinical and laboratory findings that were consistent with a compromised vaginal barrier function. CONCLUSIONS: The brief reduction in pH after vaginal lime juice application is unlikely to be virucidal in the presence of semen. Lime juice is unlikely to protect against HIV and may actually be harmful.
Authors: Gail F Shust; Sylvia Cho; Mimi Kim; Rebecca P Madan; Esmeralda M Guzman; Margaret Pollack; Julia Epstein; Hillel W Cohen; Marla J Keller; Betsy C Herold Journal: Am J Reprod Immunol Date: 2009-12-15 Impact factor: 3.886
Authors: Carol S Lackman-Smith; Beth A Snyder; Katherine M Marotte; Mark C Osterling; Marie K Mankowski; Maureen Jones; Lourdes Nieves-Duran; Nicola Richardson-Harman; James E Cummins; Brigitte E Sanders-Beer Journal: AIDS Res Ther Date: 2010-07-09 Impact factor: 2.250
Authors: Patricia S Fletcher; Sarah J Harman; Adrienne R Boothe; Gustavo F Doncel; Robin J Shattock Journal: Retrovirology Date: 2008-01-11 Impact factor: 4.602
Authors: Andrew Vallely; Lisa Fitzgerald; Voletta Fiya; Herick Aeno; Angela Kelly; Joyce Sauk; Martha Kupul; James Neo; John Millan; Peter Siba; John M Kaldor Journal: BMC Res Notes Date: 2012-11-01
Authors: Raina N Fichorova; Pai-Lien Chen; Charles S Morrison; Gustavo F Doncel; Kevin Mendonca; Cynthia Kwok; Tsungai Chipato; Robert Salata; Christine Mauck Journal: MBio Date: 2015-09-01 Impact factor: 7.867