Background: Genital human immunodeficiency virus (HIV) RNA shedding can continue despite HIV being undetectable in blood, and can be associated with transmission. Methods: We included African women on antiretroviral therapy (ART). Linear and generalized linear mixed models were used to compare the magnitude and prevalence of genital shedding, respectively, by time since ART initiation. Multivariable logistic regression with generalized estimating equations was used to assess predictors of genital shedding among women with undetectable plasma viral load (VL). Results: Among 1114 women, 5.8% of visits with undetectable plasma VL and 23.6% of visits with detectable VL had genital shedding. The proportion of visits with genital shedding decreased with time since ART initiation but the magnitude of shedding remained unchanged when plasma VL was undetectable (P = .032). Prevalence of shedding did not vary by time since ART initiation when plasma VL was detectable (P = .195), though the magnitude of shedding significantly increased (P = .04). Predictors of genital shedding were HIV disease stage, antiretroviral regimen, and genital ulcers or cervical tenderness. Discussion: In addition to ART, reducing immune activation through prevention and treatment of HIV-related conditions and genital tract infections may decrease the risk of HIV-1 shedding and potential transmission. Published by Oxford University Press for the Infectious Diseases Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.
Background: Genital human immunodeficiency virus (HIV) RNA shedding can continue despite HIV being undetectable in blood, and can be associated with transmission. Methods: We included African women on antiretroviral therapy (ART). Linear and generalized linear mixed models were used to compare the magnitude and prevalence of genital shedding, respectively, by time since ART initiation. Multivariable logistic regression with generalized estimating equations was used to assess predictors of genital shedding among women with undetectable plasma viral load (VL). Results: Among 1114 women, 5.8% of visits with undetectable plasma VL and 23.6% of visits with detectable VL had genital shedding. The proportion of visits with genital shedding decreased with time since ART initiation but the magnitude of shedding remained unchanged when plasma VL was undetectable (P = .032). Prevalence of shedding did not vary by time since ART initiation when plasma VL was detectable (P = .195), though the magnitude of shedding significantly increased (P = .04). Predictors of genital shedding were HIV disease stage, antiretroviral regimen, and genital ulcers or cervical tenderness. Discussion: In addition to ART, reducing immune activation through prevention and treatment of HIV-related conditions and genital tract infections may decrease the risk of HIV-1 shedding and potential transmission. Published by Oxford University Press for the Infectious Diseases Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.
Authors: P S Reichelderfer; R W Coombs; D J Wright; J Cohn; D N Burns; S Cu-Uvin; P A Baron; M H Coheng; A L Landay; S K Beckner; S R Lewis; A A Kovacs Journal: AIDS Date: 2000-09-29 Impact factor: 4.177
Authors: S D Lawn; S Subbarao; T C Wright; T Evans-Strickfaden; T V Ellerbrock; J L Lennox; S T Butera; C E Hart Journal: J Infect Dis Date: 2000-05-31 Impact factor: 5.226
Authors: Susan M Graham; Sarah E Holte; Norbert M Peshu; Barbra A Richardson; Dana D Panteleeff; Walter G Jaoko; Jeckoniah O Ndinya-Achola; Kishorchandra N Mandaliya; Julie M Overbaugh; R Scott McClelland Journal: AIDS Date: 2007-02-19 Impact factor: 4.177
Authors: Susan Cu-Uvin; Allison K DeLong; Kartik K Venkatesh; Joseph W Hogan; Jessica Ingersoll; Jaclynn Kurpewski; Maria Pia De Pasquale; Richard D'Aquila; Angela M Caliendo Journal: AIDS Date: 2010-10-23 Impact factor: 4.177
Authors: Jared M Baeten; Deborah Donnell; Patrick Ndase; Nelly R Mugo; James D Campbell; Jonathan Wangisi; Jordan W Tappero; Elizabeth A Bukusi; Craig R Cohen; Elly Katabira; Allan Ronald; Elioda Tumwesigye; Edwin Were; Kenneth H Fife; James Kiarie; Carey Farquhar; Grace John-Stewart; Aloysious Kakia; Josephine Odoyo; Akasiima Mucunguzi; Edith Nakku-Joloba; Rogers Twesigye; Kenneth Ngure; Cosmas Apaka; Harrison Tamooh; Fridah Gabona; Andrew Mujugira; Dana Panteleeff; Katherine K Thomas; Lara Kidoguchi; Meighan Krows; Jennifer Revall; Susan Morrison; Harald Haugen; Mira Emmanuel-Ogier; Lisa Ondrejcek; Robert W Coombs; Lisa Frenkel; Craig Hendrix; Namandjé N Bumpus; David Bangsberg; Jessica E Haberer; Wendy S Stevens; Jairam R Lingappa; Connie Celum Journal: N Engl J Med Date: 2012-07-11 Impact factor: 91.245
Authors: Kimdar Sherefa Kemal; Brian Foley; Harold Burger; Kathryn Anastos; Howard Minkoff; Christina Kitchen; Sean M Philpott; Wei Gao; Esther Robison; Susan Holman; Carolyn Dehner; Suzanne Beck; William A Meyer; Alan Landay; Andrea Kovacs; James Bremer; Barbara Weiser Journal: Proc Natl Acad Sci U S A Date: 2003-10-13 Impact factor: 11.205
Authors: Josè Ramòn Fiore; Barbara Suligoi; Annalisa Saracino; Mariantonietta Di Stefano; Roberto Bugarini; Achiropita Lepera; Anna Favia; Laura Monno; Gioacchino Angarano; Giuseppe Pastore Journal: AIDS Date: 2003-10-17 Impact factor: 4.177
Authors: Clare Tanton; Helen A Weiss; Jerome Le Goff; John Changalucha; Mary Rusizoka; Kathy Baisley; Dean Everett; David A Ross; Laurent Belec; Richard J Hayes; Deborah Watson-Jones Journal: PLoS One Date: 2011-03-01 Impact factor: 3.240
Authors: Marta Bull; Caroline Mitchell; Jaime Soria; Sheila Styrchak; Corey Williams; Joan Dragavon; Kevin J Ryan; Edward Acosta; Frankline Onchiri; Robert W Coombs; Alberto La Rosa; Eduardo Ticona; Lisa M Frenkel Journal: J Infect Dis Date: 2020-08-04 Impact factor: 5.226
Authors: Rogelio Valdez; Gabriella Fenkart; Germán G Gornalusse; Lucia Vojtech; Lamar M Fleming; Urvashi Pandey; Sean M Hughes; Claire N Levy; Erin J Dela Cruz; Fernanda L Calienes; Anna C Kirby; Michael F Fialkow; Gretchen M Lentz; Jessica Wagoner; Lichen Jing; David M Koelle; Stephen J Polyak; David N Fredricks; M Juliana McElrath; Anna Wald; Florian Hladik Journal: J Virol Date: 2020-04-16 Impact factor: 5.103
Authors: Athena P Kourtis; Jeffrey Wiener; Stacey Hurst; Julie A E Nelson; Mackenzie L Cottrell; Amanda Corbett; Lameck Chinula; Albans Msika; Lisa B Haddad; Jennifer H Tang Journal: J Acquir Immune Defic Syndr Date: 2019-06-01 Impact factor: 3.731
Authors: Julie A E Nelson; Kristina De Paris; Catalina Ramirez; Andrew Edmonds; Katie R Mollan; Camden P Bay; Kara Compliment; Betsy C Herold; Kathryn Anastos; Howard Minkoff; Seble Kassaye; Dominika L Seidman; Audrey L French; Elizabeth T Golub; Anandi N Sheth; Christina Ochsenbauer; Ronald Swanstrom; Joseph J Eron; Adaora A Adimora Journal: AIDS Date: 2020-01-01 Impact factor: 4.632
Authors: Kerry Murphy; Marla J Keller; Kathryn Anastos; Shada Sinclair; J Cooper Devlin; Qiuhu Shi; Donald R Hoover; Brian Starkman; Jamie McGillick; Caroline Mullis; Howard Minkoff; Maria Gloria Dominguez-Bello; Betsy C Herold Journal: PLoS One Date: 2019-04-26 Impact factor: 3.752
Authors: Lisa M Frenkel; R Leavitt Morrison; Trevon L Fuller; Maria Isabel Gouvêa; Maria de Lourdes Benamor Teixeira; Robert W Coombs; David E Shapiro; Mark Mirochnick; Roslyn Hennessey; Kyle Whitson; Nahida Chakhtoura; Esaú C João Journal: J Acquir Immune Defic Syndr Date: 2021-12-01 Impact factor: 3.771