Injectable contraceptive use and genital ulcer disease during the early phase of HIV-1 infection increase plasma virus load in women.
We examined the association between host factors present near the time of human immunodeficiency virus type 1 (HIV-1) acquisition and subsequent virus loads, in a prospective cohort study of women in Mombasa, Kenya. Women were prospectively followed monthly before HIV-1 infection. One hundred sixty-one commercial sex workers who became infected with HIV-1 were followed for a median of 34 months, and 991 plasma samples collected > or =4 months after infection were tested for HIV-1 RNA. The median virus set point at 4 months after infection was 4.46 log10 copies/mL, and the average virus load increase during subsequent follow-up was 0.0094 log10 copies/mL/month. In a multivariate analysis that controlled for sexual behavior, the use of the injectable contraceptive depot medroxyprogesterone acetate (DMPA) at the time of HIV-1 infection was associated with a higher virus set point, and the presence of genital ulcer disease (GUD) during the early phase of HIV-1 infection was associated with greater change in virus load during follow-up. These findings suggest that, in women, the use of DMPA and the presence of GUD during the early phase of HIV-1 infection may influence the natural course of infection.
Lavreys
Ludo
L
Department of Epidemiology, Medicine, and Biostatistics, University of Washington, Seattle, Washington 98104-2499, USA. llavreys@u.washington.edu
Baeten
Jared M
JM
Kreiss
Joan K
JK
Richardson
Barbra A
BA
Chohan
Bhavna H
BH
Hassan
Wisal
W
Panteleeff
Dana D
DD
Mandaliya
Kishorchandra
K
Ndinya-Achola
Jeckoniah O
JO
Overbaugh
Julie
J
D000163:Acquired Immunodeficiency Syndrome / Q000821:virology*; D000328:Adult; D015331:Cohort Studies; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D005260:Female; D005831:Genital Diseases, Female / Q000821:virology*; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D007267:Injections; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage*; D015999:Multivariate Analysis; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D012725:Sexual Behavior; D014456:Ulcer / Q000821:virology*; D019562:Viral Load
D003271:Contraceptive Agents, Female; D012367:RNA, Viral; D017258:Medroxyprogesterone Acetate