Correlates of human immunodeficiency virus cervicovaginal shedding among postmenopausal and fertile-aged women

Autor(es)

Melo, Keli Cardoso ^[1] ; Melo, Murilo Rezende ^[2] ; Ricci, Bruno Vita ^[1] ; Segurado, Aluisio Cotrim ^[1]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Sch Med, Dept Infect Dis, Virol Lab LIM 52, BR-05508 Sao Paulo - Brazil

^[2] Santa Casa Med Sch, Dept Physiol, Sao Paulo - Brazil

• Tipo de documento: Artigo Científico
• Fonte: MENOPAUSE-THE JOURNAL OF THE NORTH AMERICAN MENOPAUSE SOCIETY; v. 19, n. 2, p. 150-156, FEB 2012.
• Citações Web of Science: 3

Resumo

Objective: The aims of this study were to compare the intensity of human immunodeficiency virus (HIV)-RNA genital shedding among postmenopausal (PM) and fertile-aged (F) women and to investigate the association between viral shedding and gynecological features, HIV plasma viral loads, and other markers of HIV disease progression. Methods: We interviewed 146 HIV-infected women (73 PM/73 F) in search of gynecological complaints and signs and symptoms of HIV disease and obtained additional information concerning HIV infection by medical chart review. Cervicovaginal lavages (CVLs) were collected for assessment of HIV shedding. Laboratory analyses included CD4(+) cell counts, HIV-RNA quantitation in plasma and CVL, and screening for concurrent genital infections. Results: HIV-RNA genital shedding was detected in 16.4% of PM and 21.9% of F women (P = 0.400), and the intensity of HIV shedding did not differ between both groups (means-PM: 1.4log/mL; F: 1.4log/mL; P = 0.587). Three women (2 PM/1 F) exhibited viral shedding in the absence of detectable viremia. HIV plasma viral loads correlated with HIV shedding in both groups. In multivariable analysis, HIV plasma viral loads were independently associated with HIV shedding in both groups. Moreover, the intensity of shedding was independently associated with vaginal pH, tumor necrosis factor a concentrations in CVL, and HIV plasma viral loads. Conclusions: Despite significant changes that occur in the vaginal mucosa of PM women, HIV cervicovaginal shedding was not significantly influenced by this state in our cohort. In contrast, increased vaginal pH and genital inflammation, evidenced by increased tumor necrosis factor alpha concentrations in CVL and HIV plasma viral loads, were independently associated with the intensity of HIV shedding in PM and F women. (AU)

• Processo FAPESP: 05/50182-1 - Avaliação da excreção genital do HIV-1 em mulheres menopausadas e em idade fértil
• Beneficiário: Aluisio Augusto Cotrim Segurado
• Modalidade de apoio: Auxílio à Pesquisa - Regular