Six-day randomized safety trial of intravaginal lime juice.
OBJECTIVE
Nigerian women reportedly apply lime juice intravaginally to protect themselves against HIV. In vitro data suggest that lime juice is virucidal, but only at cytotoxic concentrations. This is the first controlled, randomized safety trial of lime juice applied to the human vagina.


METHODS
Forty-seven women were randomized to apply water or lime juice (25%, 50%, or undiluted) intravaginally twice daily for two 6-day intervals, separated by a 3-week washout period. Product application also was randomized: during 1 interval, product was applied using a saturated tampon and in the other by douche. Vaginal pH, symptoms, signs of irritation observed via naked eye examination and colposcopy, microflora, and markers of inflammation in cervicovaginal lavages were evaluated after 1 hour and on days 3 and 7.


RESULTS
The largest reduction in pH was about one-half a pH unit, seen 1 hour after douching with 100% lime juice. We observed a dose-dependent pattern of symptoms and clinical and laboratory findings that were consistent with a compromised vaginal barrier function.


CONCLUSIONS
The brief reduction in pH after vaginal lime juice application is unlikely to be virucidal in the presence of semen. Lime juice is unlikely to protect against HIV and may actually be harmful.
CONRAD, Eastern Virginia Medical School, Arlington, VA 22209, USA. cmauck@conrad.org
Christine K
CK
Mauck
Susan A
SA
Ballagh
Mitchell D
MD
Creinin
Debra H
DH
Weiner
Gustavo F
GF
Doncel
Raina N
RN
Fichorova
Jill L
JL
Schwartz
Neelima
N
Chandra
Marianne M
MM
Callahan
D000328:Adult; D000891:Anti-Infective Agents, Local / Q000009:adverse effects*; D032082:Citrus aurantiifolia; D016207:Cytokines / Q000032:analysis; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008875:Middle Aged; D014621:Vagina / Q000187:drug effects* / Q000276:immunology / Q000382:microbiology / Q000473:pathology; D044364:Vaginal Douching / Q000379:methods*
D000891:Anti-Infective Agents, Local; D016207:Cytokines