Tampons as a self-administered collection method for the detection and quantification of genital HIV-1.
OBJECTIVE
To assess the detection and quantitation of HIV-1 from tampon eluents in comparison with cervicovaginal lavage (CVL) and plasma specimens from the same women.


METHODS
Ninety-seven tampon, 105 CVL, and 104 plasma specimens from 105 HIV-1 seropositive women were analyzed using Version 3 of the Chiron bDNA assay, with sensitivity of 50 HIV-1 RNA copies/ml. Data analyses used McNemar's test, Wilcoxon signed rank test, and Mantel--Haenszel chi-squared and odds ratios with 95% confidence intervals to assess differences in proportions.


RESULTS
In women for whom both plasma and genital specimens were available, HIV-1 was detected less frequently in genital specimens: [tampons (33/97, 34%) and CVL (48/104, 46%)] than plasma specimens (86/104, 83%) (P < 0.001 for both plasma versus tampon and for plasma versus CVL). However, the proportion of genital specimens with detectable virus did not differ significantly by collection method (P = 0.14). Among women with detectable virus using both collection methods (n = 23), viral load was similar for tampon eluents (median, 355 copies/ml; range, 52--120,898) and CVL specimens (median, 265 copies/ml; range, 61--35,637;P = 0.88).


CONCLUSIONS
Tampon eluent specimens are slightly less sensitive than CVL specimens in the detection of genital HIV-1, although quantification of viral load, when detectable by both methods, was similar.
Webber
M P
MP
The Department of Epidemiology and Social Medicine, AIDS Research Program, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York 10467, USA.
Schoenbaum
E E
EE
Farzadegan
H
H
Klein
R S
RS
D000328:Adult; D002584:Cervix Uteri / Q000378:metabolism / Q000821:virology; D003627:Data Interpretation, Statistical; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000821:virology; D015497:HIV-1; D006801:Humans; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D012680:Sensitivity and Specificity; D013048:Specimen Handling / Q000379:methods*; D013630:Tampons, Surgical; D007507:Therapeutic Irrigation; D014621:Vagina / Q000378:metabolism / Q000821:virology; D019562:Viral Load
D012367:RNA, Viral