Cervicovaginal human immunodeficiency virus secretion and plasma viral load in human immunodeficiency virus-seropositive women.
OBJECTIVE
To evaluate human immunodeficiency virus (HIV)-1 RNA burden in paired plasma and cervicovaginal lavage specimens and to assess the relation of plasma HIV-1 RNA level, CD4 cell count, and antiretroviral therapy with cervicovaginal HIV-1 viral load.


METHODS
Paired blood and cervicovaginal lavage specimens were collected from 72 HIV-infected women. Quantitation of HIV-1 RNA from plasma and cervicovaginal lavage specimens was performed by using the nucleic acid sequence-based amplification assay. Analyses examined relations between cervicovaginal HIV-1 RNA and plasma HIV-1 RNA level, CD4 count, and antiretroviral therapy.


RESULTS
Plasma HIV-1 RNA was detectable in 61 of 72 women (85%), with copy numbers ranging from 330 to 1,600,000 copies/mL. Twenty-eight of 72 (39%) had detectable HIV-1 RNA in cervicovaginal lavage specimens, ranging from 320 to 440,000 copies/mL. The cervicovaginal lavage HIV-1 RNA level was detectable in 9%, 29%, 52%, and 53% of the women with plasma HIV-1 RNA of less than 400, 400-9999, 10,000-100,000, and more than 100,000 copies, respectively (P = .043). Among women with CD4 counts of less than 200, 200-500, and greater than 500/mm3, cervicovaginal lavage HIV-1 RNA was detected in 67%, 32%, and 25% of subjects, respectively (P = .018). Among women receiving antiretroviral therapy, cervicovaginal lavage revealed HIV-1 RNA in 67%, 31%, and 25% with CD4 cell counts of less than 200, 200-500, and more than 500/mm3, respectively (P = .042).


CONCLUSIONS
The presence of HIV-1 RNA in cervicovaginal lavage correlates significantly with the level of HIV-1 RNA in plasma and negatively with CD4 cell count.
Uvin
S C
SC
Immunology Center, The Miriam Hospital, Brown University, Providence, Rhode Island 02906, USA.
Caliendo
A M
AM
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D002584:Cervix Uteri / Q000378:metabolism / Q000821:virology*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D006679:HIV Seropositivity; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D012367:RNA, Viral / Q000097:blood; D007507:Therapeutic Irrigation; D014621:Vagina / Q000378:metabolism / Q000821:virology*; D019562:Viral Load
D019380:Anti-HIV Agents; D012367:RNA, Viral