Comparison of cervicovaginal lavage, cervicovaginal lavage enriched with cervical swab, and vaginal tampon for the detection of HIV-1 RNA and HSV-2 DNA in genital secretions.
METHODS
We compared the performance of 3 collection methods for cervicovaginal secretions [cervicovaginal lavage (CVL), CVL enriched with a cervical swab (eCVL), and vaginal tampon (VT)] to identify the most reliable method for detection of cervicovaginal HIV-1 and herpes simplex virus type 2 (HSV-2). HIV-1 RNA (Nuclisens EasyQ; BioMerieux, Marcy-l'Etoile, France), HSV-2 DNA (real-time polymerase chain reaction), and microscopic blood and semen traces were detected in samples from 19 HIV-1-HSV-2-coinfected women seen at 4 weekly visits.


RESULTS
HIV-1 RNA was detected in 49 (79%) of 62 eCVLs, 41 (61%) of 67 CVLs, and 27 (57%) of 47 VTs. Detection of HIV-1 RNA was higher in eCVL compared with CVL [45/58 (78%) vs. 32/58 (55%); risk ratio 1.41, 95% confidence interval 1.05 to 1.88].


CONCLUSIONS
Although more eCVLs were contaminated with microscopic blood (29%) than CVLs (22%) or VTs (7%), detection of HIV-1 RNA remained higher using eCVL compared with CVL (risk ratio 1.43, 95% confidence interval 1.02 to 2.02) in uncontaminated samples. HSV-2 DNA was detected in less than 10% of samples by each method but in 7 (37%) of 19 women overall by 1 or more methods.
Delany
Sinéad
S
Reproductive Health and HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa. sdelany@rhru.co.za
Rosas
Raul
R
Mlaba
Nonkululeko
N
Clayton
Tim
T
Akpomiemie
Godspower
G
LeGoff
Jérôme
J
Capovilla
Alexio
A
Bélec
Laurent
L
Stevens
Wendy
W
Mayaud
Philippe
P
D000293:Adolescent; D000328:Adult; D002584:Cervix Uteri / Q000378:metabolism / Q000821:virology; D004279:DNA, Viral / Q000302:isolation & purification*; D005260:Female; D005836:Genitalia, Female / Q000378:metabolism / Q000821:virology*; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis / Q000821:virology; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification*; D006558:Herpes Genitalis / Q000150:complications / Q000175:diagnosis / Q000821:virology; D018258:Herpesvirus 2, Human / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D052576:Menstrual Hygiene Products; D012367:RNA, Viral / Q000302:isolation & purification*; D013048:Specimen Handling / Q000295:instrumentation; D007507:Therapeutic Irrigation; D014621:Vagina / Q000378:metabolism / Q000821:virology; D055815:Young Adult
D004279:DNA, Viral; D012367:RNA, Viral