title: Variation of human immunodeficiency virus type 1 viral RNA levels in the female genital tract: implications for applying measurements to individual women.
abstract: The short-term detection and variability of human immunodeficiency virus type 1 (HIV-1) RNA level was assessed in the blood plasma and genital tracts of 55 HIV-1-infected women. Specimens were collected weekly for 8 weeks from the endocervical canal with wicks and cytobrushes and from the ectocervix and vagina with cervicovaginal lavage. In all, 48 women (87.3%) had detectable genital tract HIV-1 RNA at > or =1 collection times. HIV-1 RNA levels varied least in specimens from endocervical canal wick and most in cervicovaginal lavage samples. The within-subject variation for genital-tract virus level was greater than that for blood. Overall, the odds for viral RNA detection in the genital tract approximately tripled for each 10-fold increase in plasma viral RNA concentration (P<.001) or with concomitant genital tract infection (P=.003). Endocervical canal wicks should be considered as an adjunct to cervicovaginal lavage, to improve the sensitivity and precision of HIV-1 RNA detection.
authors.affiliation: Department of Laboratory Medicine, University of Washington, Seattle, WA 98104-2499, USA. bcoombs@u.washington.edu
authors.forename: R W
authors.initials: RW
authors.lastname: Coombs
authors.forename: D J
authors.initials: DJ
authors.lastname: Wright
authors.forename: P S
authors.initials: PS
authors.lastname: Reichelderfer
authors.forename: D N
authors.initials: DN
authors.lastname: Burns
authors.forename: J
authors.initials: J
authors.lastname: Cohn
authors.forename: S
authors.initials: S
authors.lastname: Cu-Uvin
authors.forename: P A
authors.initials: PA
authors.lastname: Baron
authors.forename: M H
authors.initials: MH
authors.lastname: Cohen
authors.forename: A L
authors.initials: AL
authors.lastname: Landay
authors.forename: S
authors.initials: S
authors.lastname: Lewis
authors.forename: A
authors.initials: A
authors.lastname: Kovacs
mesh_terms: D002584:Cervix Uteri / Q000821:virology; D005260:Female; D014644:Genetic Variation; D005836:Genitalia, Female / Q000821:virology*; D015658:HIV Infections / Q000821:virology*; D015497:HIV-1 / Q000235:genetics / Q000502:physiology*; D006801:Humans; D008597:Menstrual Cycle; D021141:Nucleic Acid Amplification Techniques / Q000379:methods; D012367:RNA, Viral / Q000032:analysis* / Q000097:blood; D013048:Specimen Handling / Q000379:methods; D014621:Vagina / Q000821:virology; D017201:Virus Shedding
chemical_list: D012367:RNA, Viral