title: Low-dose combined oral contraceptive and cervicovaginal shedding of human immunodeficiency virus.
abstract: BACKGROUND
  The role of low-dose oral contraceptives on HIV cervicovaginal shedding among HIV-positive women is controversial.
  
  
  METHODS
  We evaluated the effect of low-dose oral contraceptives on HIV cervicovaginal shedding in a cohort of 285 HIV-seropositive women followed for a median of 20 months. A sensitive, competitive polymerase chain reaction (cPCR) and a reverse transcription PCR (cRT-PCR) were applied for the quantification of HIV-associated and cell-free RNA and proviral DNA in cervicovaginal cells, as well as HIV-RNA in plasma.
  
  
  RESULTS
  In multivariable logistic generalized estimating equations, plasma viral load >100 copies/mL (OR=1.81, 95% CI=1.3-2.53) and bacterial vaginosis (OR=1.49, 95% CI=1.1-2.02) were associated with an increased risk of HIV-1 DNA shedding, whereas current use of oral contraceptive was associated with a reduced risk (OR=0.55, 95% CI=0.33-0.92). Oral contraceptives were also associated with a reduction of risk (OR=0.38, 95% CI=0.21-0.69) of cell-associated but not cell-free HIV-1 RNA.
  
  
  CONCLUSIONS
  In HIV-positive women with low levels of HIV viremia, low-dose oral contraceptives were associated with a modest but significant reduction of HIV-1 DNA and cell-associated HIV-1 RNA genital shedding.
authors.affiliation: Department of Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy. mariannaroccio@yahoo.it
authors.forename: Marianna
authors.initials: M
authors.lastname: Roccio
authors.forename: Barbara
authors.initials: B
authors.lastname: Gardella
authors.forename: Renato
authors.initials: R
authors.lastname: Maserati
authors.forename: Francesca
authors.initials: F
authors.lastname: Zara
authors.forename: Daniela
authors.initials: D
authors.lastname: Iacobone
authors.forename: Arsenio
authors.initials: A
authors.lastname: Spinillo
mesh_terms: D000328:Adult; D003277:Contraceptives, Oral, Combined / Q000008:administration & dosage*; D005260:Female; D005836:Genitalia, Female / Q000821:virology; D006679:HIV Seropositivity / Q000635:transmission*; D006801:Humans; D011446:Prospective Studies; D012367:RNA, Viral / Q000032:analysis*; D012959:Socioeconomic Factors; D017201:Virus Shedding / Q000187:drug effects*; D055815:Young Adult
chemical_list: D003277:Contraceptives, Oral, Combined; D012367:RNA, Viral