title: Genital HIV-1 viral load is correlated with blood plasma HIV-1 viral load in Brazilian women and is reduced by antiretroviral therapy.
abstract: BACKGROUND
  Cervicovaginal secretions represent the primary vehicle in mother to infant and sexual HIV-1 transmission. Understanding the viral dynamics in this compartment is important to improve interventions to decrease HIV transmission.
  
  
  OBJECTIVE
  To evaluate the correlation of HIV-1 blood plasma viral load and cervicovaginal HIV-1 viral load and the effect of antiretroviral therapy (ART) on cervicovaginal HIV-1 viral load.
  
  
  METHODS
  A cross-sectional study among HIV-1 infected women recruited between February 2002 and January 2003 and a longitudinal study that included 11 women who initiated ART were performed. HIV-1 viral load was measured in the female genital tract and in blood plasma using the Nuclisens assay before and 1 month after ART introduction.
  
  
  RESULTS
  HIV-1 viral load in cervicovaginal lavage was significantly correlated with HIV-1 blood plasma viral load (n = 27, Spearman rho = 0.73, p<0.001). In the longitudinal study, antiretroviral therapy was associated with a reduction of 1.44 log10 on genital HIV-1 viral load (95% CI = 0.57-2.30, p = 0.004, Student's t-test).
  
  
  CONCLUSIONS
  HIV-1 viral load in female genital secretions is correlated with blood plasma HIV-1 viral load. Antiretroviral therapy substantially reduces HIV-1 viral load in the female genital tract.
authors.affiliation: Infectious Diseases Service, Department of Preventive Medicine, Hospital Universitário Clementino Fraga Filho, School of Medicine, Universidade Federal do Rio de Janeiro, Brazil.
authors.forename: Marcelo Vianna
authors.initials: MV
authors.lastname: Vettore
authors.forename: Mauro
authors.initials: M
authors.lastname: Schechter
authors.forename: Maria Fátima
authors.initials: MF
authors.lastname: Melo
authors.forename: Luciana Jandre
authors.initials: LJ
authors.lastname: Boechat
authors.forename: Paulo Feijó
authors.initials: PF
authors.lastname: Barroso
mesh_terms: D000328:Adult; D000480:Alkynes; D044966:Anti-Retroviral Agents / Q000494:pharmacology / Q000627:therapeutic use*; D048588:Benzoxazines / Q000494:pharmacology / Q000627:therapeutic use; D001938:Brazil / Q000453:epidemiology; D002584:Cervix Uteri / Q000821:virology; D003430:Cross-Sectional Studies; D003521:Cyclopropanes; D005260:Female; D005836:Genitalia, Female / Q000821:virology*; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology*; D015497:HIV-1 / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D019259:Lamivudine / Q000494:pharmacology / Q000627:therapeutic use; D008137:Longitudinal Studies; D019888:Nelfinavir / Q000494:pharmacology / Q000627:therapeutic use; D015995:Prevalence; D013997:Time Factors; D014621:Vagina / Q000821:virology; D019562:Viral Load; D015215:Zidovudine / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000480:Alkynes; D044966:Anti-Retroviral Agents; D048588:Benzoxazines; D003521:Cyclopropanes; D019259:Lamivudine; D015215:Zidovudine; D019888:Nelfinavir; C098320:efavirenz