title: Residual HIV-1 RNA and HIV-1 DNA production in the genital tract reservoir of women treated with HAART: the prospective ANRS EP24 GYNODYN study.
abstract: BACKGROUND
  The female genital tract constitutes a reservoir for HIV providing active production of both cell-free HIV RNA and cell-associated DNA within the cervicovaginal secretions. The objective of this study was to prospectively assess residual HIV-1 RNA and HIV-1 DNA production in the genital tract reservoir of women initiating HAART over an 18-month period.
  
  
  METHODS
  Paired blood and cervicovaginal lavage samples were collected at inclusion and 1, 6, 12 and 18 months after HAART initiation, in 23 women in first-line HAART and six women in virological failure, for measurement of HIV-1 RNA and HIV-1 DNA shedding and/or drug concentrations.
  
  
  RESULTS
  A dramatic decrease of HIV-1 RNA and HIV-1 DNA occurred in both blood and cervicovaginal samples over the first 6 months on HAART, followed by a shelf up to 18 months, independently of the drugs' genital pharmacokinetics. While cervicovaginal HIV-1 RNA became undetectable in >90% of women from 6 months on HAART, genital HIV-1 DNA remained frequently detectable (27-50%). Nearly 40% of women with sustained undetectable plasma HIV-1 RNA after 6-18 months on HAART harboured transient HIV-1 RNA (15% of women) or HIV-1 DNA (31% of women) in their genital secretions.
  
  
  CONCLUSIONS
  Low-level cervicovaginal HIV-1 shedding is frequently evidenced in HAART-treated women with transient HIV-1 RNA and persistent HIV-1 DNA despite a systemic control of viral replication, resulting in possible residual genital infectivity.
authors: Faculté de Médecine Paris Descartes, Université Paris Descartes, Paris, France. odile.launay@cch.aphp.fr
authors: Odile
authors: O
authors: Launay
authors: Michel
authors: M
authors: Tod
authors: Inga
authors: I
authors: Tschöpe
authors: Ali
authors: A
authors: Si-Mohamed
authors: Linda
authors: L
authors: Bélarbi
authors: Charlotte
authors: C
authors: Charpentier
authors: Cécile
authors: C
authors: Goujard
authors: Anne-Marie
authors: AM
authors: Taburet
authors: Olivier
authors: O
authors: Lortholary
authors: Valériane
authors: V
authors: Leroy
authors: Laurent
authors: L
authors: Bélec
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000493:pharmacokinetics / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D004279:DNA, Viral / Q000096:biosynthesis; D005260:Female; D005836:Genitalia, Female / Q000821:virology*; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology*; D015497:HIV-1 / Q000235:genetics*; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D011533:Proviruses / Q000235:genetics; D012367:RNA, Viral / Q000096:biosynthesis; D019562:Viral Load; D017201:Virus Shedding; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents; D004279:DNA, Viral; D012367:RNA, Viral