title: HIV-1 and herpes simplex virus type-2 genital shedding among co-infected women using self-collected swabs in Chiang Rai, Thailand.
abstract: We analysed 528 genital self-collected swabs (SCS) from 67 HIV-1 and herpes simplex virus type-2 (HSV-2) co-infected women collected during the placebo month of a randomized crossover clinical trial of suppressive acyclovir in Chiang Rai, Thailand. In this first longitudinal study of HIV-1 and HSV-2 co-infected women using genital SCS specimens, we found frequent mucosal HIV-1 shedding. Overall, 372 (70%) swabs had detectable HIV-1 RNA with median HIV-1 viral load of 2.61 log(10) copies/swab. We found no statistically significant association between detectable HIV-1 RNA and HSV-2 DNA in the same SCS specimen (adjusted odds ratio [aOR] 1.40; 95% confidence intervals [CI], 0.78-2.60, P = 0.25). Only baseline HIV-1 plasma viral load was independently associated with genital HIV-1 RNA shedding (aOR, 7.6; 95% CI, 3.3-17.2, P < 0.0001). SCS may be useful for future HIV-1 and HSV-2 studies because this method allows for frequent genital sampling, and inclusion of genital sites other than the cervix.
authors.affiliation: Epidemic Intelligence Service, Office of Workforce and Career Development, Centers for Disease Control and Prevention, Atlanta, GA, USA. sforhan@cdc.gov
authors.forename: S E
authors.initials: SE
authors.lastname: Forhan
authors.forename: E F
authors.initials: EF
authors.lastname: Dunne
authors.forename: M R
authors.initials: MR
authors.lastname: Sternberg
authors.forename: S J
authors.initials: SJ
authors.lastname: Whitehead
authors.forename: W
authors.initials: W
authors.lastname: Leelawiwat
authors.forename: S
authors.initials: S
authors.lastname: Thepamnuay
authors.forename: C
authors.initials: C
authors.lastname: Chen
authors.forename: Tt
authors.initials: T
authors.lastname: Evans-Strickfaden
authors.forename: J M
authors.initials: JM
authors.lastname: McNicholl
authors.forename: L E
authors.initials: LE
authors.lastname: Markowitz
mesh_terms: D000328:Adult; D060085:Coinfection; D005260:Female; D005836:Genitalia, Female / Q000821:virology*; D015658:HIV Infections / Q000150:complications / Q000821:virology*; D015497:HIV-1 / Q000502:physiology*; D006558:Herpes Genitalis / Q000150:complications / Q000821:virology*; D018258:Herpesvirus 2, Human / Q000502:physiology*; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D060888:Real-Time Polymerase Chain Reaction; D013785:Thailand; D017201:Virus Shedding; D055815:Young Adult